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Published on: June 12, 2021
Hospitalization-related economic impact of patients with cardiogenic shock in a high-complexity reference centre
Elena Collado1, Daniele Luiso1, Albert Ariza-Solé1
1Cardiology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Carrer de la Feixa Llarga s/n, Barcelona 08907, Spain.
Insights
Caring for patients with cardiogenic shock (CS) in specialized centers incurs significant costs, primarily from hospital stays, especially in critical care units. However, the cost per life-year gained remains low, indicating value in centralized care.
Area of Science:
- Cardiology
- Health Economics
Background:
- Cardiogenic shock (CS) has high mortality rates.
- Centralized care in high-complexity centers is recommended for CS patients.
Purpose of the Study:
- To describe the hospitalization-related economic cost of CS patients.
- To identify the main determinants of these costs in a reference center.
Main Methods:
- Retrospective, single-center study of 230 CS patients (2015-2017).
- Cost calculated using analytical accountability, including hospital stay, procedures, and devices.
- Cost per life-year gained (LYG) was determined.
Main Results:
- Mean patient cost was €17,161, with 81.1% attributed to hospital stay, particularly Critical Care Unit (CCU) stay (79.8%).
- In-hospital mortality was 38.3%. Surviving patients had significantly longer hospital stays (21.7 vs. 7.5 days).
- Total cost was €3,947,118, with a cost per LYG of €9,632.52.
Conclusions:
- Management of CS in specialized centers involves substantial economic costs.
- The primary cost driver is prolonged hospital stay, especially in CCUs.
- The cost per life-year gained is relatively low, suggesting efficient resource utilization.
Aims:
Cardiogenic shock (CS) is associated with high mortality. Current guidelines strongly recommend centralizing the care of these patients in high-complexity centres. We described the hospitalization-related economic cost and its main determinants in patients with CS in a high-complexity reference centre.
Methods And Results:
This is a single-centre, retrospective study. All patients with CS (2015-17) were included. Hospitalization-related cost per patient was calculated by analytical accountability method, including hospital stay-related expenditures, interventions, and consumption of devices. Expenditure was expressed in 2018 euros. All-cause mortality during follow-up was registered. Ratio of cost per life-year gained (LYG) was also calculated. A total of 230 patients were included, with mean age of 63 years. In-hospital mortality was 88/230 (38.3%). Hospital stay was longer in patients surviving after the admission (21.7 vs. 7.5 days, P < 0.001). Total economic cost for the overall cohort was 3 947 118€ (mean/patient 17 161€). Most of this cost was attributable to hospital stay (81.1%). The rest of the expenditure was due to in-hospital procedures (13.1%) and the use of devices (5.8%). Most of hospital stay-related costs (79.8%) were due to Critical Care Unit stay. Mean follow-up was 651 days. Total LYG was 409.77 years for the whole series. The observed ratio of cost per LYG was 9632.52 €/LYG.
Conclusions:
Management of CS in a reference centre is associated to a significant economic cost, but with a low ratio of cost per LYG. Most of this cost is attributable to hospital stay, specifically in critical care units.
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