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One third of hospital costs for atherothrombotic disease are attributable to readmissions: a linked data analysis
Emily R Atkins1, Elizabeth A Geelhoed, Matthew Knuiman
1School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, Australia. emily.atkins@uwa.edu.au.
Insights
Hospital readmissions for atherothrombotic disease cost millions, with nearly a third of total expenditure occurring within 24 months post-discharge. Further research is needed to explore secondary prevention strategies to reduce these costs.
Area of Science:
- Health Economics
- Cardiovascular Research
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of death in Australia, incurring significant healthcare costs.
- Hospital admissions for CVD represent a substantial portion of this expenditure.
- Atherothrombotic disease admissions carry a significant economic burden, necessitating investigation into post-discharge costs.
Purpose of the Study:
- To investigate health outcomes and hospital expenditure following an atherothrombotic disease admission.
- To analyze the components of hospital costs in the two years after initial admission.
- To quantify the economic impact of readmissions for atherothrombotic conditions.
Main Methods:
- Utilized data linkage of hospitalisation and death records for patients aged 35-84 admitted for atherothrombotic disease in Western Australia in 2007.
- Matched Australian refined diagnostic related groups to public and private hospital cost schedules.
- Converted all costs to 2013 Australian dollars for analysis.
Main Results:
- Of 6172 patients, 13% died within two years; 32% experienced 3172 readmissions.
- Patients with multiple vascular territories affected had a 1.45-fold increased hazard of readmission.
- Total index and 2-year readmission costs amounted to $101 million, with $30 million attributed to readmissions.
Conclusions:
- Readmissions for atherothrombotic disease account for nearly one-third of total healthcare costs within 24 months.
- A significant portion of readmission costs occurred within the first year post-discharge.
- The potential for secondary prevention measures to reduce readmission rates and associated costs requires further study.
Background:
Cardiovascular disease is the most frequent cause of death in Australia, with an associated cost burden of 11% of Australian annual health expenditure of which 40% is for hospital admissions. We investigated health outcomes and the components of hospital expenditure in the two years after an atherothrombotic disease admission to a tertiary hospital in an Australian setting.
Methods:
Using data linkage we analysed two years of hospitalisation data and death records of all men and women aged 35-84 years with an admission to a Western Australian tertiary hospital for atherothrombotic disease in 2007. Costs were identified by matching the Australian refined diagnostic related group on the admission records to the published schedules of public and private hospital costs for the period of interest, and converted to 2013 Australian dollars.
Results:
Of 6172 patients studied (74% coronary, 20% cerebrovascular, 6% peripheral), 783 (13%) died during follow-up and 174 of these were in hospital case-fatalities at index. Thirty-two percent of patients (n = 1965) accounted for 3172 readmissions to hospital with one in three having multiple hospitalisations. The hazard ratio of atherothrombotic disease readmission was 1.45 (95% CI 1.27, 1.66) in those with more than one vascular territory affected compared to those with only one territory affected after controlling for age, sex, comorbidity, admission type, procedures, and episode length of stay. The total index plus 2-year admission cost for atherothrombotic disease was calculated at $101 million; $71 million for index, and $30 million for readmissions.
Conclusions:
Among patients hospitalised with atherothrombotic disease, the cost of related rehospitalisations within 24 months is almost a third of the total. Much of the readmission costs fell within the first year. Whether readmissions and cost associated with atherothrombotic disease can be lowered through secondary prevention measures requires further investigation.
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