Determinants of inpatient costs of angina pectoris, myocardial infarction, and heart failure in a university hospital setting in Turkey

Abstract

Objective:This study aimed to determine the correlates of in-hospital costs for angina pectoris (AP), myocardial infarction (MI), and heart failure (HF) in a university hospital setting.Methods:This is a retrospective cost-of-illness study using data from the records of patients who were admitted with AP, MI, or HF to Dokuz Eylül University Hospital during 2008. Direct medical costs were calculated from the Social Security Institute perspective using a bottom-up approach. Socio-demographic and clinical information was abstracted from patient files. Costs were presented in Turkish lira (TL). A generalized linear model was used in the multivariate analysis.Results:We included 337 in-patients in total in the study. AP was present in 26.4% (n=89), MI was present in 55.8% (n=188), and HF was present in 17.8% (n=60) of patients. MI was the most costly disease (2760 TL), followed by HF (2350 TL) and AP (1881 TL). The largest proportion of the total cost was formed by medical interventions (27.5%), followed by surgery (22.2%). Presence of DM, smoking, diagnosis of MI, HF, need for intensive care, and resulting in death were strong predictors of treatment costs.Conclusion:Both preadmission characteristics of patients (diabetes mellitus, smoking, use of anti-aggregant before admission) and in-patient characteristics (diagnosis, coronary artery bypass grafting, intensive care need, death) predicted the hospital cost of cardiovascular diseases (CVDs) independently. Our results may be used as input for health-economic models and economic evaluations to support the decision-making of reimbursement and the cost-effectiveness of public health interventions in healthcare.

Cost of heart failure management in Turkey: results of a Delphi Panel

“…Turkish Atherosclerosis Cost Study (2009), which provided data from five centers related with the hospitalizations due to HF in 2007, reported the mean duration of hospitalization as 6.6 days, the total cost of stay as 1617 €, and daily cost of stay as 245 €/day (Unpublished data). On the other hand, the length of stay for HF patients reported by Sözmen et al (14) and Ergin et al (27) was 10.6 and 10 days, respectively. Average length of stay for HF was reported as 9.4 days in academic hospitals in Turkey (28).…”

“…According to the results of the study by Sözmen et al (14), the total in-hospital cost of a HF patient per admission is 2.351 TL, and cost per day is 258 TL. They reported that unit cost regarding surgical interventions was the highest, followed by medical supplies, laboratory tests, and ward costs.…”

“…The retrospective cost-of-illness study conducted in a university hospital setting in Turkey in 2008 by Sözmen et al (14) calculated the total cost of HF patients per admission as 2351 TL. The recent data based on expert panel views by Fak et al (15), reported the cost for HF as 2435 TL per patient.…”

“…A retrospective cost-of-illness study conducted in a university hospital setting in Turkey in 2008 used in-hospital cost data from the records of patients who admitted to the hospital with angina pectoris, myocardial infarction, or HF and stated that HF was the second most costly disease (14). It was reported that patients diagnosed with HF or myocardial infarction had significantly higher mean costs compared to patients with angina pectoris (14). They calculated the daily cost of HF patients as 258 TL and the total cost per admission as 2351 TL (14).…”

“…It was reported that patients diagnosed with HF or myocardial infarction had significantly higher mean costs compared to patients with angina pectoris (14). They calculated the daily cost of HF patients as 258 TL and the total cost per admission as 2351 TL (14). These findings were very similar to a recent data based on expert panel views conducted in Turkey by Fak et al (15), where cost for HF was reported as 2435 TL per patient.…”