A28-12 Demographics and Racial Disparity on Hospital Length of Stay and Hospital Charge of Patients With Chronic Thromboembolic Pulmonary Hypertension in the United States: An Insight From a Nationwide Database

Rationale Chronic thromboembolic pulmonary embolism (CTEPH) can cause frequent hospital admission. However, data on hospital length of stay and charges in this population is limited. Therefore, we performed this study to acquire hospital length of stay, hospital charge; and investigate the demographic impact on these issues. Methods We performed a retrospective descriptive study on the United States National Inpatient Sample from 01/2017 to 12/2022, using ICD-10 code and Stata 19.5 version to obtain the mean hospital length of stay and mean hospital charge of patients admitted to hospital with the principal diagnosis of CTEPH (I27.24). We used logistic regression to investigate the correlation between race, gender, age, chronic deep venous thrombosis (DVT), acute DVT and the rate of CTEPH. We also used linear regression to investigate the impact of race on both hospital length of stay and hospital charges. Results There were 5,325 cases of CTEPH. Females accounted for 50.61%. Mean age was 56.68 years old (95%CI 55.68-57.68). White was the most common race (60.40%), followed by Black (27.58%), Hispanic (6.97%), other (3.23%), Asian/Pacific Islander (1.41%), and Native American (0.40%). Compared with White patients, CTEPH rate increased in Black patients by odds ratio (OR) 2.01 (p < 0.01) and decreased in Hispanic and Asian/Pacific Islander patients by OR 0.66 (p = 0.004) and 0.55 (p = 0.041) respectively. Chronic DVT and acute DVT increased CTEPH by OR 11.08 and 3.11 respectively (p < 0.01). Patients stayed in hospital for an average of 11.19 days (95%CI 10.42-11.96) and incurred a mean hospital charge of $ 259,924.6 (95% CI 226,250.4-293,598.8). 63.39% of hospital charges were paid by Medicare and Medicaid. Compared with White patients, Asian/Pacific Islander and Native American patients had significantly shorter hospital length of stay by coefficient 3.70 (p = 0.020) and 5.09 (p = 0.003) days respectively, Black and Hispanic patients had no significant difference in hospital length of stay. Native American patients paid $ 196,000 on average less than White patients (p < 0.01). Patients of other races had no significant difference in hospital charge compared with White patients. Conclusions CTEPH rate was different among races with Black race being associated with a higher risk of CTEPH compared to White race. Hospital length of stay was long, and this was reflective in high hospital charges. The difference in hospital length of stay only occurred between patients of Asian/Pacific Islander, Native American and White race. Hospital charge was lower to Native American patients compared to White patients.