Key result
ACS-related rehospitalizations occurred in 32%-34% of patients, with CABG being the strongest predictor of increased recurrence charges in both populations.
Why the study?
This study was conducted to examine the economic consequences related to rehospitalization following initial acute coronary syndrome (ACS) treatment in United States managed care settings.
What are the rehospitalization rates and predictors of direct medical charges for ACS-related rehospitalizations following initial ACS treatment in US managed care settings?
Cohort (n=108,443)
Yes
What are the rehospitalization rates and predictors of direct medical charges for ACS-related rehospitalizations following initial ACS treatment in US managed care settings?
Approximately one-third of ACS patients in US managed care settings experience ACS-related rehospitalizations, which incur high economic costs primarily driven by CABG, PCI, and stent insertion even after adjusting for length of stay.
Answers are grounded in this paper and cite their sources.
One-third of ACS patients face rehospitalization with CABG-linked charges; this cohort study leaves open targeted prevention trials in managed care.
OBJECTIVE: To examine economic consequences related to rehospitalization following initial acute coronary syndrome (ACS) treatment in United States managed care settings. STUDY DESIGN: Retrospective observational studies. RESEARCH DESIGN AND METHODS: Retrospective observational studies were conducted on two managed care populations to examine medical encounter insurance claims and charges for ACS-related rehospitalizations following an index hospitalization for new onset ACS (2002-2007). All charges were adjusted to year 2007 United States Dollars (USDs). MAIN OUTCOME MEASURES: The main outcomes for this study were the direct charges related to ACS rehospitalizations as captured in two separate medical encounter claims databases. RESULTS: Of the 11,266 ACS patients identified for analysis in the health system plan, 3588 (32%) had at least one ACS rehospitalization. Of the 97,177 ACS patients enrolled in the nationally representative managed care database, 32,578 (34%) had at least one ACS-related rehospitalization. Multivariate analyses demonstrated that coronary artery bypass graft (CABG) was the strongest predictor of increased charges during the recurrence in both populations (p < 0.0001). When controlling for length of stay (LOS) in the model, CABG remained a significant predictor of increased charges, while percutaneous coronary intervention (PCI) and stent insertion became even stronger predictors of increased charges. CONCLUSIONS: The costs associated with ACS-related rehospitalizations in a real-world setting are high, even when controlling for known cost drivers such as length of stay.
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Berenson et al. (2009) conducted a cohort in Acute coronary syndrome (ACS) (n=108,443). ACS-related rehospitalization and revascularization (CABG, PCI, stent insertion) was evaluated on Direct medical encounter charges related to ACS rehospitalizations (adjusted to 2007 USDs) (p=<0.0001). ACS-related rehospitalizations occurred in 32%-34% of patients, with CABG being the strongest predictor of increased recurrence charges in both populations.
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