Venous Thromboembolism Prophylaxis and Risk in the Inpatient and Outpatient Continuum of Care Among Hospitalized Acutely Ill Patients in the US: A Retrospective Analysis

Amin, Alpesh; Neuman, W. Richey; Lingohr-Smith, Melissa; Menges, Brandy; Lin, Jay

doi:10.1007/s12325-018-0846-2

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…Furthermore, ICD-9 codes may not always be indicative of actual VTE events 17 , and, therefore, the VTE event rate reported in this study could have been over-estimated, as well as the costs for VTE. It has been observed in previous studies that most VTE events among patient populations similar as in this study occur within the first few months after hospital discharge 10,11 . For this study, we used an extended follow-up of 6 months to capture as many VTE events as possible among the hospitalized study population.…”

Section: Limitationssupporting

confidence: 66%

“…Such improvements may help reduce the burden of VTE readmissions. In our recent study of VTE prophylaxis patterns of 17,895 patients hospitalized for acute medical illnesses in the US, the findings were that nearly 60% did not receive any pharmacologic VTE prophylaxis, and only 7% received both inpatient and outpatient prophylaxis 10 . Although not all hospitalized acutely medically ill patients may be at high risk for VTE based on the ACCP criteria 3 , the potential under treatment of such a patient population and the accompanying irresolution regarding who is at high risk for VTE requires attention.…”

Section: Potential Predictors Of Vte-related and Vte (Primary Diagnosmentioning

confidence: 97%

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Frequency of hospital readmissions for venous thromboembolism and associated hospital costs and length of stay among acute medically ill patients in the US

Amin

Deitelzweig

Bucior

et al. 2019

Journal of Medical Economics

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Objectives: This study evaluated the frequency of hospital readmissions for venous thromboembolism (VTE) and the associated costs and length of stay (LOS) among acute medically ill patients in the US using a real-world claims database analysis. Methods: Patients (!40 years of age) at risk of VTE due to hospitalization for acute medical illnesses, based on primary hospital discharge diagnosis codes, were identified from the MarketScan databases between July 1, 2011 and March 31, 2015. Patients were required to have continuous insurance enrollment in the 6 months prior to initial (index) hospitalizations (baseline period) and in the 6 months after hospital discharge (follow-up period). The proportions of patients with VTE-related (diagnosis at any position) and VTE as primary diagnosis hospital readmissions during the follow-up period were evaluated. The associated costs and LOS for such readmissions were also determined, as well as time to VTE-related readmissions. Results: Of the study population (n ¼ 12,785; mean age ¼ 68.3 years), most were hospitalized primarily for infectious diseases (35.2%), followed by respiratory diseases (27.9%), cancer (15.7%), heart failure (11.8%), ischemic stroke (8.1%), and rheumatic diseases (1.4%). Of the overall study population, 2.1% (n ¼ 268) had a VTE-related hospital readmission in the 6 months following discharge of their index hospitalization, of which 36.6% (n ¼ 98) were for a primary diagnosis of VTE. Approximately 25.4% of the VTE-related hospital readmissions occurred within the first 30 days of discharge and 58.2% within 90 days. The mean cost for a hospital readmission with a primary diagnosis of VTE was $18,681 (mean LOS ¼ 5.0 days); for readmissions with a primary diagnosis of DVT and PE, mean costs were $14,719 and $23,305, respectively. Conclusions: Among this study population of patients hospitalized for acute medical illnesses, some experienced a VTE event requiring re-hospitalization, with 25% occurring within the first 30 days after hospital discharge.

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Section: Limitationssupporting

confidence: 66%

Section: Potential Predictors Of Vte-related and Vte (Primary Diagnosmentioning

confidence: 97%

Frequency of hospital readmissions for venous thromboembolism and associated hospital costs and length of stay among acute medically ill patients in the US

Amin

Deitelzweig

Bucior

et al. 2019

Journal of Medical Economics

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“…The majority of studies were retrospective cohort studies (77/87; 89%), and analyses were based on varied healthcare databases (55/77 studies), six of which explicitly referred to as ‘medical records’ and/or ‘chart reviews’ in the studies, administrative claims data (20/77), registry data (1/77), or combined medical records and claims data (1/77) [ESM 3]. Five studies (5/87) used an economic model populated with data from different healthcare databases [ 45 , 52 – 56 ]. A cross-sectional design, where costs were assessed at a discrete point in time, was adopted by three studies [ 57 – 59 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

et al. 2020

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Background Heart failure presents a growing clinical and economic burden in the USA. Robust cost data on the burden of illness are critical to inform economic evaluations of new therapeutic interventions. Objectives This systematic literature review of heart failure-related costs in the USA aimed to assess the quality of the published evidence and provide a narrative synthesis of current data. Methods Four electronic databases (MEDLINE, EMBASE, EconLit, and the Centre for Reviews and Dissemination York Database, including the NHS Economic Evaluation Database and Health Technology Assessment Database) were searched for journal articles published between January 2014 and March 2020. The review, registered with PROSPERO (CRD42019134201), was restricted to cost-of-illness studies in adults with heart failure events in the USA. Results Eighty-seven studies were included, 41 of which allowed a comparison of cost estimates across studies. The annual median total medical costs for heart failure care were estimated at $24,383 per patient, with heart failure-specific hospitalizations driving costs (median $15,879 per patient). Analyses of subgroups revealed that heart failure-related costs are highly sensitive to individual patient characteristics (such as the presence of comorbidities and age) with large variations even within a subgroup. Additionally, differences in study design and a lack of standardized reporting limited the ability to compare cost estimates. The finding that costs are higher for patients with heart failure with reduced ejection fraction compared with patients with preserved ejection fraction highlights the need for differentiating among different heart failure types. Conclusions The review underpins the conclusion drawn in earlier reviews, namely that hospitalization costs are the key driver of heart failure-related costs. Analyses of subgroups provide a clearer understanding of sources of heterogeneity in cost data. While current cost estimates provide useful indications of economic burden, understanding the nuances of the data is critical to support its application. Electronic supplementary material The online version of this article (10.1007/s40273-020-00952-0) contains supplementary material, which is available to authorized users.

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“…Patients and their families are the most important stakeholders affected by the devastating effects of VTEs which can include the death of the patient. VTEs are a prominent cause of unnecessary morbidity and mortality amongst hospitalized patients in the United States (Amin, Neuman, Lingohr-Smith, Menges & Lin, 2019). Even globally, VTEs are a prominent source of death and disability (Amin, Neuman, Lingohr-Smith, Menges & Lin, 2019).…”

Section: Stakeholdersmentioning

confidence: 99%

“…VTEs are a prominent cause of unnecessary morbidity and mortality amongst hospitalized patients in the United States (Amin, Neuman, Lingohr-Smith, Menges & Lin, 2019). Even globally, VTEs are a prominent source of death and disability (Amin, Neuman, Lingohr-Smith, Menges & Lin, 2019). These statistics are frightening and preventable.…”

Section: Stakeholdersmentioning

confidence: 99%

12. Venous Thromboembolism Prevention

Dobesh¹,

Aker²

2018

Anticoagulation Therapy

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Venous Thromboembolism Prophylaxis and Risk in the Inpatient and Outpatient Continuum of Care Among Hospitalized Acutely Ill Patients in the US: A Retrospective Analysis

Cited by 8 publications

References 22 publications

Frequency of hospital readmissions for venous thromboembolism and associated hospital costs and length of stay among acute medically ill patients in the US

Frequency of hospital readmissions for venous thromboembolism and associated hospital costs and length of stay among acute medically ill patients in the US

A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

12. Venous Thromboembolism Prevention

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