Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction
Healthcare resource utilization (HRU) peaks in the last year-of-life, and accounts for a substantial share of healthcare expenditure. We evaluated changes in HRU and costs throughout the last year-of-life among AMI survivors and investigated whether such changes can predict imminent mortality. This...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/8/2773 |
| _version_ | 1797604947752124416 |
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| author | Ygal Plakht Harel Gilutz Jonathan Eli Arbelle Dan Greenberg Arthur Shiyovich |
| author_facet | Ygal Plakht Harel Gilutz Jonathan Eli Arbelle Dan Greenberg Arthur Shiyovich |
| author_sort | Ygal Plakht |
| collection | DOAJ |
| description | Healthcare resource utilization (HRU) peaks in the last year-of-life, and accounts for a substantial share of healthcare expenditure. We evaluated changes in HRU and costs throughout the last year-of-life among AMI survivors and investigated whether such changes can predict imminent mortality. This retrospective analysis included patients who survived at least one year following an AMI. Mortality and HRU data during the 10-year follow-up period were collected. Analyses were performed according to follow-up years that were classified into mortality years (one year prior to death) and survival years. Overall, 10,992 patients (44,099 patients-years) were investigated. Throughout the follow-up period, 2,885 (26.3%) patients died. The HRU parameters and total costs were strong independent predictors of mortality during a subsequent year. While a direct association between mortality and hospital services (length of in-hospital stay and emergency department visits) was observed, the association with ambulatory services utilization was reversed. The discriminative ability (c-statistics) of a multivariable model including the HRU parameters for predicting the mortality in the subsequent year, was 0.88. In conclusion, throughout the last year of life, hospital-centered HRU and costs of AMI survivors increase while utilization of ambulatory services decrease. HRUs are strong and independent predictors of an imminent mortality year among these patients. |
| first_indexed | 2024-03-11T04:54:04Z |
| format | Article |
| id | doaj.art-75a72e88f1874d32b01e36ac2f6933c6 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:54:04Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-75a72e88f1874d32b01e36ac2f6933c62023-11-17T19:48:17ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128277310.3390/jcm12082773Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial InfarctionYgal Plakht0Harel Gilutz1Jonathan Eli Arbelle2Dan Greenberg3Arthur Shiyovich4Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelGoldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelGoldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelDepartment of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USAHealthcare resource utilization (HRU) peaks in the last year-of-life, and accounts for a substantial share of healthcare expenditure. We evaluated changes in HRU and costs throughout the last year-of-life among AMI survivors and investigated whether such changes can predict imminent mortality. This retrospective analysis included patients who survived at least one year following an AMI. Mortality and HRU data during the 10-year follow-up period were collected. Analyses were performed according to follow-up years that were classified into mortality years (one year prior to death) and survival years. Overall, 10,992 patients (44,099 patients-years) were investigated. Throughout the follow-up period, 2,885 (26.3%) patients died. The HRU parameters and total costs were strong independent predictors of mortality during a subsequent year. While a direct association between mortality and hospital services (length of in-hospital stay and emergency department visits) was observed, the association with ambulatory services utilization was reversed. The discriminative ability (c-statistics) of a multivariable model including the HRU parameters for predicting the mortality in the subsequent year, was 0.88. In conclusion, throughout the last year of life, hospital-centered HRU and costs of AMI survivors increase while utilization of ambulatory services decrease. HRUs are strong and independent predictors of an imminent mortality year among these patients.https://www.mdpi.com/2077-0383/12/8/2773acute myocardial infarctionhealthcare resource utilizationcostsprognosisfollow-up |
| spellingShingle | Ygal Plakht Harel Gilutz Jonathan Eli Arbelle Dan Greenberg Arthur Shiyovich Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction Journal of Clinical Medicine acute myocardial infarction healthcare resource utilization costs prognosis follow-up |
| title | Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction |
| title_full | Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction |
| title_fullStr | Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction |
| title_full_unstemmed | Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction |
| title_short | Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction |
| title_sort | healthcare resources utilization throughout the last year of life after acute myocardial infarction |
| topic | acute myocardial infarction healthcare resource utilization costs prognosis follow-up |
| url | https://www.mdpi.com/2077-0383/12/8/2773 |
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