The economic impact of acute coronary syndrome on length of stay: An analysis using the Healthcare Cost and Utilization Project (HCUP) databases.

Journal of Medical Economics (Impact Factor: 1.58). 01/2014; 17(3). DOI: 10.3111/13696998.2014.885907
Source: PubMed


To assess the economic impact of initial and repeat hospitalizations associated with acute coronary syndrome (ACS) over 1 year (2009).

Design and methods:
National- and state-level data on length of stay (LOS) and related charges for ACS-associated hospital admissions were assessed using two Healthcare Utilization Project databases. The first, the Nationwide Inpatient Sample (NIS), provided clinical and resource use information from ∼8 million hospital stays, representing a 20% stratified sample of ∼40 million annual hospital stays in the US in 2009. The second, the State Inpatient Databases, provided 100% of inpatient data from nine states that included both patient age and linked information on multiple patient admissions within the same calendar year. For patients with repeat admissions, the LOS, primary diagnosis, and total charges between the first and subsequent admissions were evaluated. All patients≥18 years of age with at least one diagnosis of ACS, defined using the International Classification of Diseases, 9th Revision, were included (code 410.xx [except 410.x2], 411.1x and 411.8x). Variables evaluated for each discharge included demographics, cardiovascular events and procedures, LOS, discharge status, and total charges.

The NIS reported 1,437,735 discharges for ACS in 2009. In this dataset, mean LOS for an initial ACS event was 5.56 days. Patients>65 years of age had the highest numbers of admissions; this group also had the most comorbidities. Approximately 40% of ACS patients with data on repeat visits had more than one admission, >70% of these within 2 months of the primary discharge. Mean charges were $71,336 for the first admission and $53,290 for the second admission.

Despite a variety of new therapies to prevent ACS, it remains a common condition. Better therapies are called for if the clinical and cost burden of ACS is to be alleviated.

29 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective : To examine the occurrence of complications in patients with congenital facial anomalies who underwent orthognathic surgeries and to identify the role of patient-related factors in occurrence of complications. Design : Retrospective analysis of hospital discharge database. Setting : Nationwide inpatient sample for the years 2004 to 2010. All patients with a diagnosis of cleft lip and/or palate or congenital craniofacial anomalies and who had an orthognathic surgery were selected. Interventions : Orthognathic surgery. Main Outcome Measures : Occurrence of complications. Results : During the study period, a total of 8340 patients with congenital craniofacial anomalies underwent orthognathic surgeries. The overall complication rate was 9.1%. Six different complications (bacterial infections, hemorrhage, postoperative pneumonia, iatrogenic-induced complications such as accidental punctures/lacerations or pneumothorax, other infections, and respiratory complications) occurred in at least 1% of all patients having orthognathic surgeries. Ninety-five percent of patients were discharged routinely after surgery. Patients with high comorbid burden are at a higher risk for developing complications (P < .05). Conclusions : The current study findings indicate that orthognathic surgeries can be safely performed in patients with congenital craniofacial anomalies. The present study results reflect the practice patterns and hospitalization outcomes across the country and could serve as benchmarks for future well-designed prospective controlled studies to examine risk factors associated with complications for not only orthognathic surgeries but also for a wider range of surgical procedures.
    No preview · Article · Dec 2014 · The Cleft Palate-Craniofacial Journal