Abstract 250: Death Is Expensive: Evaluation of Inpatient Mortality for Acute Coronary Syndromes Admissions
Introduction: Most economic analyses that have addressed the costs associated with acute coronary syndromes (ACS) have only focused on patients who have survived an inpatient admission. No studies have specifically addressed the cost of dying during an ACS inpatient admission in a commercially insured population.
Methods: Medical and pharmacy claims from the Truven MarketScan databases (2009-2011) were used to identify inpatient admissions with a primary discharge diagnosis of ACS, among patients with 6 months of continuous enrollment prior to admission. Admissions with a discharge status of “death” (deceased sample) were matched (1:3 ratio) to remaining admissions (survived sample) on age, gender, year, and Charlson Comorbidity Index (CCI), creating a matched sample. Mean length of stay, total admission cost, and mean costs per day for the deceased sample were compared to thesurvived sample. All costs are reported in 2012 USD.
Results: A total of 1,160 ACS admissions with deceased discharge status were identified and matched to 3,480 ACS admissions with non-deceased (survived) status. The majority of patients were male (68%) with a mean age of 56.7±6.4 years and mean CCI ranging from 1.94-1.97. The Table summarizes a description of the ACS admissions. The average length of stay for ACS admissions with deceased status (days) were 34% higher compared to those with survived status (6.9±9.2 versus 5.2±4.8 days, respectively, p<0.0001). Similarly, the mean total cost per admission and mean cost per hospital day was 2-fold higher (p<0.0001) and 1.5-fold higher respectively (p<0.0001) for ACS admissions with deceased status compared to those with survived status. The first day of admission was the most expensive for both admissions; although 1.8-fold higher for the deceased sample (p<0.0001) compared to the survived sample. Similar trend continued for subsequent days of admission between both admissions.
Conclusion: ACS admissions with deceased status are both expensive and longer in duration compared to those with survived status. These data can provide financial insights to hospitals regarding their case mix for resource allocation in managing their ACS population.
Author Disclosures: R.L. Page: None. V. Ghushchyan: None. G. Hoetzer: A. Employment; Significant; Astra Zeneca. D. Bhandary: A. Employment; Significant; Astra Zeneca. J. Den Bos: None. T. Gray: None. D.T. Norris: None. K.V. Nair: None.
- © 2014 by American Heart Association, Inc.