Direct healthcare costs and resource consumption after acute coronary syndrome: a real-life analysis of an Italian subpopulation

Roggeri, Daniela Paola; Roggeri, Alessandro; Rossi, Elisa; Cinconze, E.; Rosa, Marisa De; Maggioni, Aldo P.

doi:10.1177/2047487313483608

Cited by 13 publications

(10 citation statements)

References 28 publications

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“…Ischemic heart disease is associated with a substantial healthcare burden worldwide, in terms of both deaths and disability-adjusted life years [ 1 ], while the costs of treating acute coronary syndromes (ACS) also represent a major burden for healthcare systems globally [ 2 – 6 ]. With the increasing prevalence of lifestyle-related chronic-disease risk factors, increasing healthcare costs, technological innovation, and growing consumer and patient expectations regarding access to twenty-first century healthcare, it is expected this burden will likely continue to increase [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia

Jan

Lee

Sawhney

et al. 2018

BMC Cardiovasc Disord

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BackgroundThe EPICOR Asia (long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients in Asia) study (NCT01361386) was an observational study of patients hospitalized for acute coronary syndromes (ACS) enrolled in 218 hospitals in eight countries/regions in Asia. This study examined costs, length of stay and the predictors of high costs during an ACS hospitalization.Methods and resultsData for patients hospitalized for an ACS (n = 12,922) were collected on demographics, medical history, event characteristics, socioeconomic and insurance status at discharge. Patients were followed up at 6 weeks’ post-hospitalization for an ACS event to assess associated treatment costs from a health sector perspective. Primary outcome was the incurring of costs in the highest quintile by country and index event diagnosis, and identification of associated predictors. Cost data were available for 10,819 patients. Mean length of stay was 10.1 days. The highest-cost countries were China, Singapore, and South Korea. Significant predictors of high-cost care were age, male sex, income, country, prior disease history, hospitalization in 3 months before index event, no dependency before index event, having an invasive procedure, hospital type and length of stay.ConclusionsSubstantial variability exists in healthcare costs for hospitalized ACS patients across Asia. Of concern is the observation that the highest costs were reported in China, given the rapidly increasing numbers of procedures in recent years.Trial registration NCT01361386 . Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0859-4) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia

Jan

Lee

Sawhney

et al. 2018

BMC Cardiovasc Disord

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“…5 Furthermore, drugs for the cV system in italy represented the most widely used drug class, costing over 5€ billion (6.6 USD billion), almost completely covered by the italian national Health Service (inHS). 7 However, direct healthcare costs of patients discharged from hospitals with 1 of the 3 different clinical acS conditions [St-elevation myocardial infarction (SteMi), non-St-elevation myocardial infarction (nSteMi), or unstable angina (Ua)] have never been studied in an italian real-world setting. 7 However, direct healthcare costs of patients discharged from hospitals with 1 of the 3 different clinical acS conditions [St-elevation myocardial infarction (SteMi), non-St-elevation myocardial infarction (nSteMi), or unstable angina (Ua)] have never been studied in an italian real-world setting.…”

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confidence: 99%

Resource Consumption and Healthcare Costs of Acute Coronary Syndrome

Roggeri¹,

Gnavi²,

Dalmasso³

et al. 2013

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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The objective of this study was to estimate resource consumption and direct healthcare costs of patients with a first hospitalization for acute coronary syndrome (ACS) in 2008 in the Piedmont Region, Italy. Subjects hospitalized with a first episode of ACS in 2008 were selected from the regional hospital discharge database. All hospitalizations, drug prescriptions, and outpatient episodes of care in the 12 months following discharge were considered to estimate resource consumption and direct healthcare costs from the Piedmont Regional Health Service perspective. The analysis was carried out separately for ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA) populations. In the accrual period, 7765 subjects (1.75‰ of the total population) were hospitalized for ACS (64.2% men). The average age was 66.5 for men and 75.4 for women. The average in-hospital mortality was 6.5% (n = 508). The total ACS population was classified as: STEMI 45.2%, NSTEMI 29.4%, and UA 25.4%. The average yearly costs per patient alive at the end of follow-up (n = 6851) were 14,160.8&OV0556; (18,678.7 USD): 83.9% for inpatient admissions [11,881.2&OV0556; (15,671.8 USD)], 9.3% for drugs [1311.6&OV0556; (1730.1 USD)], 5.0% for diagnostic and therapeutic procedures and outpatient visits [708.2&OV0556; (934.1 USD)], and 1.8% for 1-day hospital stays [259.8&OV0556; (342.7 USD)]. The average yearly direct healthcare costs by ACS event were 14,984.5&OV0556; (19,765.2 USD) for STEMI, 14,554.1&OV0556; (19,197.4 USD) for NSTEMI, and 12,481.5&OV0556; (16,463.6 USD) for UA. In each subpopulation, costs were significantly higher for men than for women. ACS imposes a significant burden in terms of morbidity and mortality and generates major public health service costs.

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“…Is seems that the most plausible reason for these findings is the significant age difference between the sexes (with females approximately eight years older than male patients) as a strong positive association between age and SLOS (but not PAV) was observed. Nevertheless, sex-related disparities in other characteristics and in in-hospital and post-discharge management of AMI patients were previously described and could, at least partially, explain reduced hospital referral and admission (both self-referral and referral by caregivers [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between Subsequent Hospitalizations and Primary Ambulatory Services Utilization within the First Year after Acute Myocardial Infarction and Long-Term Mortality

Plakht

Greenberg

Gilutz

et al. 2020

JCM

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Healthcare resource utilization peaks throughout the first year following acute myocardial infarction (AMI). Data linking the former and outcomes are sparse. We evaluated the associations between subsequent length of in-hospital stay (SLOS) and primary ambulatory visits (PAV) within the first year after AMI and long-term mortality. This retrospective analysis included patients who were discharged following an AMI. Study groups: low (0–1 days), intermediate (2–7) and high (≥8 days) SLOS; low (<10) and high (≥10 visits) PAV, throughout the first post-AMI year. All-cause mortality was set as the primary outcome. Overall, 8112 patients were included: 55.2%, 23.4% and 21.4% in low, intermediate and high SLOS groups respectively; 26.0% and 74.0% in low and high-PAV groups. Throughout the follow-up period (up to 18 years), 49.6% patients died. Multivariable analysis showed that an increased SLOS (Hazard ratio (HR) = 1.313 and HR = 1.714 for intermediate and high vs. low groups respectively) and a reduced number of PAV (HR = 1.24 for low vs. high groups) were independently associated with an increased risk for mortality (p < 0.001 for each). Long-term mortality following AMI is associated with high hospital and low primary ambulatory services utilization throughout the first-year post-discharge. Measures focusing on patients with increased SLOS and reduced PAV should be considered to improve patient outcomes.

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Direct healthcare costs and resource consumption after acute coronary syndrome: a real-life analysis of an Italian subpopulation

Abstract: Patients with ACS had higher direct healthcare costs, their management and rehospitalizations being the main cost drivers.

Cited by 13 publications

References 28 publications

Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia

Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia

Resource Consumption and Healthcare Costs of Acute Coronary Syndrome

Associations between Subsequent Hospitalizations and Primary Ambulatory Services Utilization within the First Year after Acute Myocardial Infarction and Long-Term Mortality

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