Cost of Hospital Care for Older Adults with Heart Failure: Medical, Pharmaceutical, and Nursing Costs

Abstract

Objective. To determine the impact of patient characteristics, clinical conditions, hospital unit characteristics, and health care interventions on hospital cost of patients with heart failure. Data Sources/Study Setting. Data for this study were part of a larger study that used electronic clinical data repositories from an 843-bed, academic medical center in the Midwest. Study Design. This retrospective, exploratory study used existing administrative and clinical data from 1,435 hospitalizations of 1,075 patients 60 years of age or older. A cost model was tested using generalized estimating equations (GEE) analysis. Data Collection/Extraction Methods. Electronic databases used in this study were the medical record abstract, the financial data repository, the pharmacy repository; and the Nursing Information System repository. Data repositories were merged at the patient level into a relational database and housed on an SQL server. Principal Findings. The model accounted for 88 percent of the variability in hospital costs for heart failure patients 60 years of age and older. The majority of variables that were associated with hospital cost were provider interventions. Each medical procedure increased cost by $623, each unique medication increased cost by $179, and the addition of each nursing intervention increased cost by $289. One medication and several nursing interventions were associated with lower cost. Nurse staffing below the average and residing on 2-4 units increased hospital cost. Conclusions. The model and data analysis techniques used here provide an innovative and useful methodology to describe and quantify significant health care processes and their impact on cost per hospitalization. The findings indicate the importance of conducting research using existing clinical data in health care.

Empowering Adult Stem Cells for Myocardial Regeneration V2.0

“…Consequently, CVD is the leading cause of morbidity and mortality worldwide with approximately 400,000 new cases per year (a total diagnosis affecting over 28 million people) [5,6]. The total US healthcare cost for diagnosis and treatment of CVD exceeds $32 billion per year with a 50% mortality rate within 5 years of diagnosis [5,7]. Of individuals suffering with CVD, approximately 5 million people suffer heart failure (HF) [5].…”

“…Of individuals suffering with CVD, approximately 5 million people suffer heart failure (HF) [5]. Deaths from HF exceeds that of either breast or colon cancer [7]. The most common cause of HF in the Western World is ischemic heart disease fundamentally rooted in loss of functional cardiac tissue [8].…”

Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

“…34,35 The cost of running an inpatient sleep consult program that provides a sleep physician consult, sleep study set up by sleep technician, and trial of auto-PAP is variable, based on staffi ng and the number of patients tested. However, using our data, we estimate the cost to range from $40,000-$60,000 annually.…”

Heart Failure Hospitalization by Race/Ethnicity, Gender and Age in California: Implications for Prevention

“…26 Additionally, we estimated age-specific prevalence for each age category (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44), 45-54, 55-64, 65-74, 75-84, and ≥85 years), gender, and age-specific prevalence ratios (PR) of HF for each sub-group. Differences in the prevalence of HF risk factors by gender, race/ethnicity and age were evaluated with the Pearson χ2 and the Fisher's Exact Tests.…”