Employment status after coronary bypass operations and some cost considerations.

The occupational consequences and expenses of the bypass operation have been investigated in 100 survivors of 102 consecutive operations for coronary artery bypass grafting. There was one late death 8 months after the operation, and four patients were lost to follow-up, providing a total of 95 patients for survey. Patients were divided into four groups: I, those working before and after the operation (43); II, those working before but not after the operation (18); III, those not working before the operation who returned to work after the operation (8); IV, those not working before or after the operation (26). The four groups were analyzed for age, type of employment, severity of disease, ventricular function, incidence of perioperative infarction, graft patency, postoperative treadmill performance, and exepnses incurred. Profiles of the four groups have emerged which may have predictive value. Group I patients tend to be under age 55, self-employed in higher skill occupations, and with significant left ventricular dysfunction. Group II patients tend to be over age 55, employed in lower skill occupations, but also without significant left ventricular function. Of the 34 patients unemployed for 6 months in 24 months before the operation, 24% (eight) returned to work after the operation. The typical total bill for diagnosis and treatment was $15,000, of which insurance paid $12,000 and the patient paid $3,000.