Resource Consumption and Healthcare Costs of Acute Coronary Syndrome

Roggeri, Alessandro; Gnavi, Roberto; Dalmasso, Marco; Rusciani, Raffaella; Giammaria, Massimo; Anselmino, M.; Roggeri, Daniela Paola

doi:10.1097/hpc.0b013e3182a78c06

Cited by 11 publications

(4 citation statements)

References 13 publications

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“…This is perhaps further evidenced by the positive association between hospitalization in the 3 months prior to the index event and high costs. Similar findings for male sex are consistent with a study in Italy where costs incurred by men were significantly greater than that for women, irrespective of index-event type [ 8 ]. Reports that women who present with ACS may be evaluated less intensively than men, may go some way towards explaining this [ 20 ].…”

Section: Discussionsupporting

confidence: 91%

“…Evidence from the US, comparing inpatient resource use for ACS in patients who died in hospital with that for a surviving ACS cohort, indicated that inpatient mortality for ACS is associated with a 47% greater duration of hospital stay along with an incremental cost of around US$43,000 [ 7 ]. Similarly, in a study conducted in Italy, which followed up patients for 12 months’ post-hospitalization for ACS, patients who died of a cardiovascular event had an average cost of around €16,000 compared with an average cost of around €11,000 for the entire ACS cohort [ 8 ]. In China, a small study in a single hospital in Shandong found that increased age was associated with increased treatment costs and poorer clinical outcomes [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 91%

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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“… 37 An Italian real-world study, performed in 2008, showed that direct health care costs were at least 50% higher in patients with a recurrent ACS compared with patients without recurrent ACS. 38 In particular, Roggeri et al 38 showed that, in an Italian health care setting, the average yearly costs per patient alive at the end of the follow-up period and in treatment with DAPT were €20,554 in the group of patients with recurrent ACS and €13,303 in the group of patients without recurrent ACS, respectively.…”

Section: Discussionmentioning

confidence: 99%

All-cause mortality, cardiovascular events, and health care costs after 12 months of dual platelet aggregation inhibition after acute myocardial infarction in real-world patients: findings from the Platelet-aggregation Inhibition: Persistence with treatment and cardiovascular Events in Real world (PIPER) study

Esposti¹,

Perrone²,

Veronesi³

et al. 2018

VHRM

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ObjectivesThe aim of the study was to assess all-cause mortality and cardiovascular (CV) events in patients after a period of 12 months of treatment with dual antiplatelet therapy (DAPT) after hospitalization for acute myocardial infarction (AMI) in a real-world setting. Health care costs for the management of patients post-AMI was also assessed.MethodsA retrospective analysis using data from the administrative databases of six local health units (LHUs) was performed. All beneficiaries of these LHUs hospitalized with AMI between January 01, 2010, and December 31, 2011, and exposed to a treatment period with DAPT up to 12 months after AMI discharge were included. All-cause mortality, CV hospitalizations, and health care costs occurring during the 36-month follow-up period from end of treatment with DAPT were considered. For the cost analysis, only patients still alive at the end of the follow-up period were included.ResultsA total of 2,721 patients were included (mean ± SD age 63.6±17.3 years, 67.8% males). About 17% and 18% of all patients had CV events and died during the follow-up period, respectively. The annual mean cost per patient was €3,523.27. During the follow-up period, 63 patients had a second AMI event; for whom, the mean health care cost per patient was €19,570.70.ConclusionIn a real-world setting in Italy, considering a 36-month follow-up period, all-cause mortality, CV events, and related health care cost of patients hospitalized with an AMI undergoing a 12-month treatment period with DAPT remained relevant. This study suggests that increased efforts aimed at the prevention of recurrent AMI are warranted, as well as an accurate risk stratification in order to improve long-term outcome.

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“…There are several recent studies that have examined the costs of CVD-related events, and especially so with a focus on short-term healthcare costs due to CVD-related events [ 3 – 10 ]. These studies have not included patients based on a diagnosis of or treatment for hyperlipidemia but instead included patients hospitalized for CV events [ 3 , 10 , 11 ], patients with atherosclerosis [ 4 ], hypertension [ 5 ], or acute coronary syndrome [ 6 , 7 , 12 ], or used a prevalence-based approach [ 8 , 9 ]. Only a few studies have examined the long-term costs associated with CVD-related events [ 3 , 10 , 11 ] and stratified by specific event types [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Healthcare costs associated with cardiovascular events in patients with hyperlipidemia or prior cardiovascular events: estimates from Swedish population-based register data

et al. 2015

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Objectives To estimate healthcare costs of new cardiovascular (CV) events (myocardial infarction, unstable angina, revascularization, ischemic stroke, transient ischemic attack, heart failure) in patients with hyperlipidemia or prior CV events. Methods A retrospective population-based cohort study was conducted using Swedish national registers and electronic medical records. Patients with hyperlipidemia or prior CV events were stratified into three cohorts based on CV risk level: history of major cardiovascular disease (CVD), coronary heart disease (CHD) risk-equivalent, and low/unknown risk. Propensity score matching was applied to compare patients with new events to patients without new events for estimation of incremental costs of any event and by event type.Results A CV event resulted in increased costs over 3 years of follow-up, with the majority of costs occurring in the 1st year following the event. The mean incremental cost of patients with a history of major CVD (n = 6881) was €8588 during the 1st year following the event. This was similar to that of CHD risk-equivalent patients (n = 3226; €6663) and patients at low/unknown risk (n = 2497; €8346). Ischemic stroke resulted in the highest 1st-year cost for patients with a history of major CVD and CHD risk-equivalent patients (€10,194 and €9823, respectively); transient ischemic attack in the lowest (€3917 and €4140). Incremental costs remained elevated in all cohorts during all three follow-up years, with costs being highest in the major CVD history cohort. Conclusions Healthcare costs of CV events are substantial and vary considerably by event type. Incremental costs remain elevated for several years after an event.

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Resource Consumption and Healthcare Costs of Acute Coronary Syndrome

Cited by 11 publications

References 13 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

Healthcare costs associated with cardiovascular events in patients with hyperlipidemia or prior cardiovascular events: estimates from Swedish population-based register data

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