Key result
Inpatient death during an acute coronary syndrome admission was associated with a 47% longer length of stay (IRR 1.47; 95% CI 1.37-1.57) and $43,107 higher total admission costs compared to survival.
Why the study?
What is the difference in length of stay and total admission cost between patients who die during an ACS admission versus those who survive?
Cohort (n=2,639)
What is the difference in length of stay and total admission cost between patients who die during an ACS admission versus those who survive?
Relative Risk: 1.47 (95% CI 1.37–1.57)
Inpatient death during an ACS admission is associated with significantly higher length of stay and total admission costs compared to surviving the admission.
Substantial resource burden accompanies fatal ACS admissions; leaves open whether strategies to prevent in-hospital death can reduce costs.
BACKGROUND: No studies have addressed the cost of inpatient mortality during an acute coronary syndrome (ACS) admission. OBJECTIVE: Compare ACS-related length of stay (LOS), total admission cost, and total admission cost by day of discharge/death for patients who died during an inpatient admission with a matched cohort discharged alive following an ACS-related inpatient stay. METHODS: Medical and pharmacy claims (2009-2012) were used to identify admissions with a primary diagnosis of ACS from patients with at least 6 months of continuous enrollment prior to an ACS admission. Patients who died during their ACS admission (deceased cohort) were matched (one-to-one) to those who survived (survived cohort) on age, sex, year of admission, Chronic Condition Index score, and prior revascularization. Mean LOS, total admission cost, and total admission cost by the day of discharge/death for the deceased cohort were compared with the survived cohort. A generalized linear model with log transformation was used to estimate the differences in the total expected incremental cost of an ACS admission and by the day of discharge/death between cohorts. A negative binomial model was used to estimate differences in the LOS between the two cohorts. Costs were inflated to 2013 dollars. RESULTS: A total of 1,320 ACS claims from patients who died (n=1,320) were identified and matched to 1,319 claims from the survived patients (n=1,319). The majority were men (68%) and mean age was 56.7±6.4 years. The LOS per claim for the deceased cohort was 47% higher (adjusted incidence rate ratio: 1.47, 95% confidence interval: 1.37-1.57) compared with claims from the survived cohort. Compared with the survived cohort, the adjusted mean incremental total cost of ACS admission claims from the deceased cohort was US$43,107±US$3,927 (95% confidence interval: US$35,411-US$50,803) higher. CONCLUSION: Despite decreasing ACS hospitalizations, the economic burden of inpatient death remains high.
No takes yet. Share an insight, caveat, or question.
Page et al. (2016) conducted a cohort in Acute coronary syndrome (n=2,639). Inpatient death during ACS admission vs. Survival during ACS admission was evaluated on Length of stay (IRR 1.47, 95% CI 1.37-1.57). Inpatient death during an acute coronary syndrome admission was associated with a 47% longer length of stay (IRR 1.47; 95% CI 1.37-1.57) and $43,107 higher total admission costs compared to survival.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: