Hospital Costs of Acute Pulmonary Embolism

被引:92
作者
Fanikos, John [1 ]
Rao, Amanda [2 ]
Seger, Andrew C. [2 ]
Carter, Danielle [1 ]
Piazza, Gregory [2 ]
Goldhaber, Samuel Z. [2 ]
机构
[1] Brigham & Womens Hosp, Dept Pharm, Boston, MA 02115 USA
[2] Harvard Univ, Div Cardiovasc, Dept Med, Sch Med,Brigham & Womens Hosp, Boston, MA 02115 USA
关键词
Economics; Hospital cost; Pulmonary embolism; Venous thromboembolism; DEEP-VEIN THROMBOSIS; SYMPTOMATIC VENOUS THROMBOEMBOLISM; OUTPATIENT TREATMENT; ORAL RIVAROXABAN; OUTCOMES; TRIAL; ENOXAPARIN; PREVENTION; MANAGEMENT; MORTALITY;
D O I
10.1016/j.amjmed.2012.07.025
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE: Pulmonary embolism places a heavy economic burden on health care systems, but the components of hospital cost have not been elucidated. We evaluated hospitalized patients with the primary diagnosis of pulmonary embolism. Our goal was to determine the total and component costs associated with their hospital care. METHODS: We included patients hospitalized at Brigham and Women's Hospital from September 2003 to May 2010. Patient demographics, characteristics, comorbidities, interventions, and treatments were obtained from the electronic medical record. Costs were obtained using the hospital's accounting software and categorized into the areas providing direct patient supplies or care. RESULTS: We identified 991 hospitalized patients with acute pulmonary embolism. In-hospital mortality was 4.2%, and 90-day mortality after hospital discharge was 13.8%. The median length of hospital stay was 3 days, and the mean length of hospital stay was 4 days. The mean total hospitalization cost per patient was $8764. Nursing costs, which included room and board, were $5102. Pharmacy ($966) and radiology ($963) costs were similar. Pharmacy costs ($966) were dominated by the use of low-molecular-weight heparin ($232). Radiology costs ($963) were dominated by the use of diagnostic imaging examinations ($672). During the observation period, an average of 160 patients with pulmonary embolism were admitted each year, requiring an annual hospital expense ranging from $884,814 to $1,866,489. CONCLUSIONS: Pulmonary embolism has a high case fatality rate and remains an expensive illness to diagnose and treat. Nursing costs comprise the largest component of costs. (C) 2013 Elsevier Inc. All rights reserved. The American Journal of Medicine (2013) 126, 127-132
引用
收藏
页码:127 / 132
页数:6
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