The cost of inpatient death associated with acute coronary syndrome
Robert L Page II,1 Vahram Ghushchyan,2 Jill Van Den Bos,3 Travis J Gray,3 Greta L Hoetzer,4 Durgesh Bhandary,4 Kavita V Nair1 1Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 2College of Business and...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-02-01
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| Series: | Vascular Health and Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-cost-of-inpatient-death-associated-with-acute-coronary-syndrome-peer-reviewed-article-VHRM |
| _version_ | 1828430278102614016 |
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| author | Page II RL Ghushchyan V Van Den Bos J Gray TJ Hoetzer GL Bhandary D Nair KV |
| author_facet | Page II RL Ghushchyan V Van Den Bos J Gray TJ Hoetzer GL Bhandary D Nair KV |
| author_sort | Page II RL |
| collection | DOAJ |
| description | Robert L Page II,1 Vahram Ghushchyan,2 Jill Van Den Bos,3 Travis J Gray,3 Greta L Hoetzer,4 Durgesh Bhandary,4 Kavita V Nair1 1Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 2College of Business and Economics, American University of Armenia, Yerevan, Armenia; 3Milliman, Inc, Denver, CO, 4AstraZeneca, US Medical Affairs, Wilmington, DE, USA Background: No studies have addressed the cost of inpatient mortality during an acute coronary syndrome (ACS) admission. Objective: Compare ACS-related length of stay (LOS), total admission cost, and total admission cost by day of discharge/death for patients who died during an inpatient admission with a matched cohort discharged alive following an ACS-related inpatient stay. Methods: Medical and pharmacy claims (2009–2012) were used to identify admissions with a primary diagnosis of ACS from patients with at least 6 months of continuous enrollment prior to an ACS admission. Patients who died during their ACS admission (deceased cohort) were matched (one-to-one) to those who survived (survived cohort) on age, sex, year of admission, Chronic Condition Index score, and prior revascularization. Mean LOS, total admission cost, and total admission cost by the day of discharge/death for the deceased cohort were compared with the survived cohort. A generalized linear model with log transformation was used to estimate the differences in the total expected incremental cost of an ACS admission and by the day of discharge/death between cohorts. A negative binomial model was used to estimate differences in the LOS between the two cohorts. Costs were inflated to 2013 dollars. Results: A total of 1,320 ACS claims from patients who died (n=1,320) were identified and matched to 1,319 claims from the survived patients (n=1,319). The majority were men (68%) and mean age was 56.7±6.4 years. The LOS per claim for the deceased cohort was 47% higher (adjusted incidence rate ratio: 1.47, 95% confidence interval: 1.37–1.57) compared with claims from the survived cohort. Compared with the survived cohort, the adjusted mean incremental total cost of ACS admission claims from the deceased cohort was US$43,107±US$3,927 (95% confidence interval: US$35,411–US$50,803) higher. Conclusion: Despite decreasing ACS hospitalizations, the economic burden of inpatient death remains high. Keywords: death, acute coronary syndrome, hospitalization, cost, health resource utilization |
| first_indexed | 2024-12-10T17:45:19Z |
| format | Article |
| id | doaj.art-11539b01aeb541f7a0ed4d7c7b502200 |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-12-10T17:45:19Z |
| publishDate | 2016-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-11539b01aeb541f7a0ed4d7c7b5022002022-12-22T01:39:14ZengDove Medical PressVascular Health and Risk Management1178-20482016-02-012016Issue 1132125458The cost of inpatient death associated with acute coronary syndromePage II RLGhushchyan VVan Den Bos JGray TJHoetzer GLBhandary DNair KVRobert L Page II,1 Vahram Ghushchyan,2 Jill Van Den Bos,3 Travis J Gray,3 Greta L Hoetzer,4 Durgesh Bhandary,4 Kavita V Nair1 1Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 2College of Business and Economics, American University of Armenia, Yerevan, Armenia; 3Milliman, Inc, Denver, CO, 4AstraZeneca, US Medical Affairs, Wilmington, DE, USA Background: No studies have addressed the cost of inpatient mortality during an acute coronary syndrome (ACS) admission. Objective: Compare ACS-related length of stay (LOS), total admission cost, and total admission cost by day of discharge/death for patients who died during an inpatient admission with a matched cohort discharged alive following an ACS-related inpatient stay. Methods: Medical and pharmacy claims (2009–2012) were used to identify admissions with a primary diagnosis of ACS from patients with at least 6 months of continuous enrollment prior to an ACS admission. Patients who died during their ACS admission (deceased cohort) were matched (one-to-one) to those who survived (survived cohort) on age, sex, year of admission, Chronic Condition Index score, and prior revascularization. Mean LOS, total admission cost, and total admission cost by the day of discharge/death for the deceased cohort were compared with the survived cohort. A generalized linear model with log transformation was used to estimate the differences in the total expected incremental cost of an ACS admission and by the day of discharge/death between cohorts. A negative binomial model was used to estimate differences in the LOS between the two cohorts. Costs were inflated to 2013 dollars. Results: A total of 1,320 ACS claims from patients who died (n=1,320) were identified and matched to 1,319 claims from the survived patients (n=1,319). The majority were men (68%) and mean age was 56.7±6.4 years. The LOS per claim for the deceased cohort was 47% higher (adjusted incidence rate ratio: 1.47, 95% confidence interval: 1.37–1.57) compared with claims from the survived cohort. Compared with the survived cohort, the adjusted mean incremental total cost of ACS admission claims from the deceased cohort was US$43,107±US$3,927 (95% confidence interval: US$35,411–US$50,803) higher. Conclusion: Despite decreasing ACS hospitalizations, the economic burden of inpatient death remains high. Keywords: death, acute coronary syndrome, hospitalization, cost, health resource utilizationhttps://www.dovepress.com/the-cost-of-inpatient-death-associated-with-acute-coronary-syndrome-peer-reviewed-article-VHRMDeathAcute Coronary SyndromeHospitalizationCost |
| spellingShingle | Page II RL Ghushchyan V Van Den Bos J Gray TJ Hoetzer GL Bhandary D Nair KV The cost of inpatient death associated with acute coronary syndrome Vascular Health and Risk Management Death Acute Coronary Syndrome Hospitalization Cost |
| title | The cost of inpatient death associated with acute coronary syndrome |
| title_full | The cost of inpatient death associated with acute coronary syndrome |
| title_fullStr | The cost of inpatient death associated with acute coronary syndrome |
| title_full_unstemmed | The cost of inpatient death associated with acute coronary syndrome |
| title_short | The cost of inpatient death associated with acute coronary syndrome |
| title_sort | cost of inpatient death associated with acute coronary syndrome |
| topic | Death Acute Coronary Syndrome Hospitalization Cost |
| url | https://www.dovepress.com/the-cost-of-inpatient-death-associated-with-acute-coronary-syndrome-peer-reviewed-article-VHRM |
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