Chun Shing Kwok1, Dmitry Abramov2, Purvi Parwani3, Raktim K Ghosh4, Michelle Kittleson5, Fozia Z Ahmad6, Fakhr Al Ayoubi7, Harriette G C Van Spall8, Mamas A Mamas9. 1. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK. 2. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Department of Cardiology, Linda Loma University Health, Linda Loma, USA. 3. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Department of Cardiology, Linda Loma University Health, Linda Loma, USA. 4. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Department of Cardiology, Case Western Reserve University, Heart and Vascular Institute, MetroHealth Medical Center, Cleveland, USA. 5. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. 6. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK. 7. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Department of Cardiac Sciences KFCC, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. 8. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK; Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada. 9. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK. Electronic address: mamasmamas1@yahoo.co.uk.
Abstract
BACKGROUND: Heart failure hospitalizations are a major financial cost to healthcare systems. This study aimed to evaluate the costs associated with inpatient hospitalization. METHODS: Patients with a primary diagnosis of heart failure during a hospital admission between 2010 and 2014 in the U.S. Nationwide Readmission Database were included. The primary outcome was total cost defined by direct cost of index admission and first readmission within 30-days. RESULTS: A total of 2,645,336 patients with primary heart failure were included in the analysis. The mean ± SD total cost overall was $13,807 ± 24,145; with mean total costs of $15,618 ± 25,264 for patients with 30-day readmission and $11,845 ± 22,710 for patients without a readmission. The comorbidities strongly associated with increased cost were pulmonary circulatory disorder (OR 26.24 95% CI 20.06-34.33), valvular heart disease (OR 25.42 95% CI 20.65-31.28) and bleeding (OR 5.96 95% CI 5.47-6.50). Among hospitalized patients, 12.6% underwent an invasive diagnostic procedure or treatment. The mean cost for patients without invasive care was $10,995. This increased by $129,547, $119,769, $251,110 and $293,575 for receipt of circulatory support, intra-aortic balloon pump, LV assist device and heart transplant. The greatest mean additional cost annually was associated with receipt of coronary angiogram ($26,282 per person for a total of ($728.5 million) and mechanical ventilation ($54,529 per person for a total of $501.7 million). CONCLUSION: In conclusion, the costs associated with inpatient heart failure care are significant, and the major contributors to inpatient costs are comorbidities, invasive procedures and readmissions.
BACKGROUND:Heart failure hospitalizations are a major financial cost to healthcare systems. This study aimed to evaluate the costs associated with inpatient hospitalization. METHODS:Patients with a primary diagnosis of heart failure during a hospital admission between 2010 and 2014 in the U.S. Nationwide Readmission Database were included. The primary outcome was total cost defined by direct cost of index admission and first readmission within 30-days. RESULTS: A total of 2,645,336 patients with primary heart failure were included in the analysis. The mean ± SD total cost overall was $13,807 ± 24,145; with mean total costs of $15,618 ± 25,264 for patients with 30-day readmission and $11,845 ± 22,710 for patients without a readmission. The comorbidities strongly associated with increased cost were pulmonary circulatory disorder (OR 26.24 95% CI 20.06-34.33), valvular heart disease (OR 25.42 95% CI 20.65-31.28) and bleeding (OR 5.96 95% CI 5.47-6.50). Among hospitalized patients, 12.6% underwent an invasive diagnostic procedure or treatment. The mean cost for patients without invasive care was $10,995. This increased by $129,547, $119,769, $251,110 and $293,575 for receipt of circulatory support, intra-aortic balloon pump, LV assist device and heart transplant. The greatest mean additional cost annually was associated with receipt of coronary angiogram ($26,282 per person for a total of ($728.5 million) and mechanical ventilation ($54,529 per person for a total of $501.7 million). CONCLUSION: In conclusion, the costs associated with inpatient heart failure care are significant, and the major contributors to inpatient costs are comorbidities, invasive procedures and readmissions.
Authors: Dmitry Abramov; Abdul Mannan Khan Minhas; Marat Fudim; Josh S Chung; Jay N Patel; David G Rabkin Journal: Clin Transplant Date: 2022-05-10 Impact factor: 3.456
Authors: Adeba Mohammad; Shuktika Nandkeolyar; Dennis Grewal; Antoine Sakr; Ahmed Seliem; Liset Stoletniy; Dmitry Abramov Journal: Cardiol Res Date: 2021-07-09