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Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
Arthur Shiyovich1,2, Harel Gilutz3, Jonathan Eli Arbelle3,4
1Department of Cardiology, Beilinson Hospital, Rabin Medical Center, Rabin Medical Center, 39 Jabotinski Street, 49100, Petah Tikva, Israel. arthur.shiyovich@gmail.com.
Insights
Healthcare resource utilization decreased after acute myocardial infarction (AMI), but costs remained stable. Further analysis of long-term resource allocation and enhanced ambulatory follow-up for secondary prevention are recommended.
Area of Science:
- Cardiology
- Health Economics
- Healthcare Management
Background:
- Acute myocardial infarction (AMI) significantly impacts healthcare resource utilization and expenditure.
- Understanding long-term trends in resource use and costs post-AMI is crucial for effective healthcare planning.
Purpose of the Study:
- To analyze temporal trends in healthcare resource utilization and associated costs for patients following AMI between 2003 and 2015.
- To identify changes in length of hospital stay, emergency department visits, primary care, and ambulatory services utilization and costs.
Main Methods:
- Retrospective analysis of 8047 patients surviving the first year post-hospitalization for AMI (2002-2012), followed until 2015.
- Evaluation of annual trends in length of stay (LOS), emergency department (ED) visits, primary care, and outpatient consulting clinic visits.
- Cost analysis of healthcare resource utilization over the study period.
Main Results:
- Significant decrease observed in LOS and primary care visits.
- Increase noted in ED visits and ambulatory services utilization.
- Overall healthcare costs demonstrated a decreasing trend, with multivariate analysis showing no significant change in total costs despite shifts in service utilization.
Conclusions:
- Despite reduced utilization of most healthcare services over a decade, overall healthcare expenditure following AMI remained unchanged.
- Further research into the cost-effectiveness of long-term resource allocation post-AMI is warranted.
- Emphasis on intensified ambulatory follow-up for secondary prevention and high-quality outpatient chest pain units is recommended.
Background:
Acute myocardial infarction (AMI) is associated with greater utilization of healthcare resources and financial expenditure.
Objectives:
To evaluate temporal trends in healthcare resource utilization and costs following AMI throughout 2003-2015.
Methods:
AMI patients who survived the first year following hospitalization in a tertiary medical center (Soroka University Medical Center) throughout 2002-2012 were included and followed until 2015. Length of the in-hospital stay (LOS), emergency department (ED), primary care, outpatient consulting clinic visits and other ambulatory services, and their costs, were evaluated and compared annually over time.
Results:
Overall 8047 patients qualified for the current study; mean age 65.0 (SD = 13.6) years, 30.3% women. During follow-up, LOS and the number of primary care visits has decreased significantly. However, ED and consultant visits as well as ambulatory-services utilization has increased. Total costs have decreased throughout this period. Multivariate analysis, adjusted for potential confounders, showed as significant trend of decrease in LOS and ambulatory-services utilization, yet an increase in ED visits with no change in total costs.
Conclusions:
Despite a decline in utilization of most healthcare services throughout the investigated decade, healthcare expenditure has not changed. Further evaluation of the cost-effectiveness of long-term resource allocation following AMI is warranted. Nevertheless, we believe more intense ambulatory follow-up focusing on secondary prevention and early detection, as well as high-quality outpatient chest pain unit are warranted.
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