Frequency of hospital readmissions for venous thromboembolism and associated hospital costs and length of stay among acute medically ill patients in the US

被引:13
作者
Amin, Alpesh [1 ]
Deitelzweig, Steven [2 ]
Bucior, Iwona [3 ]
Lin, Jay [4 ]
Lingohr-Smith, Melissa [4 ]
Menges, Brandy [4 ]
Neuman, W. Richey [3 ]
机构
[1] Univ Calif Irvine, Sch Med, Irvine, CA 92717 USA
[2] Univ Queensland, Sch Med, Ochsner Clin Sch, Ochsner Clin Fdn,Dept Hosp Med, New Orleans, LA USA
[3] Portola Pharmaceut, San Francisco, CA USA
[4] Novosys Hlth, Green Brook, NJ USA
关键词
Venous thromboembolism; acute medical illness; hospitalized patients; readmissions; hospital costs; THROMBOPROPHYLAXIS;
D O I
10.1080/13696998.2019.1618862
中图分类号
F [经济];
学科分类号
02 ;
摘要
Objectives: This study evaluated the frequency of hospital readmissions for venous thromboembolism (VTE) and the associated costs and length of stay (LOS) among acute medically ill patients in the US using a real-world claims database analysis. Methods: Patients (>= 40 years of age) at risk of VTE due to hospitalization for acute medical illnesses, based on primary hospital discharge diagnosis codes, were identified from the MarketScan databases between July 1, 2011 and March 31, 2015. Patients were required to have continuous insurance enrollment in the 6 months prior to initial (index) hospitalizations (baseline period) and in the 6 months after hospital discharge (follow-up period). The proportions of patients with VTE-related (diagnosis at any position) and VTE as primary diagnosis hospital readmissions during the follow-up period were evaluated. The associated costs and LOS for such readmissions were also determined, as well as time to VTE-related readmissions. Results: Of the study population (n = 12,785; mean age = 68.3 years), most were hospitalized primarily for infectious diseases (35.2%), followed by respiratory diseases (27.9%), cancer (15.7%), heart failure (11.8%), ischemic stroke (8.1%), and rheumatic diseases (1.4%). Of the overall study population, 2.1% (n = 268) had a VTE-related hospital readmission in the 6 months following discharge of their index hospitalization, of which 36.6% (n = 98) were for a primary diagnosis of VTE. Approximately 25.4% of the VTE-related hospital readmissions occurred within the first 30 days of discharge and 58.2% within 90 days. The mean cost for a hospital readmission with a primary diagnosis of VTE was $18,681 (mean LOS = 5.0 days); for readmissions with a primary diagnosis of DVT and PE, mean costs were $14,719 and $23,305, respectively. Conclusions: Among this study population of patients hospitalized for acute medical illnesses, some experienced a VTE event requiring re-hospitalization, with 25% occurring within the first 30 days after hospital discharge.
引用
收藏
页码:1119 / 1125
页数:7
相关论文
共 16 条
[1]   Venous Thromboembolism Prophylaxis and Risk in the Inpatient and Outpatient Continuum of Care Among Hospitalized Acutely Ill Patients in the US: A Retrospective Analysis [J].
Amin, Alpesh ;
Neuman, W. Richey ;
Lingohr-Smith, Melissa ;
Menges, Brandy ;
Lin, Jay .
ADVANCES IN THERAPY, 2019, 36 (01) :59-71
[2]   Results of a venous thromboembolism prophylaxis program for hospitalized patients [J].
Cardoso, Luiz Francisco ;
Krokoscz, Daniella Vianna C. ;
de Paiva, Edison Ferreira ;
Furtado, Ilka Spinola ;
Mattar, Jorge, Jr. ;
de Souza e Sa, Marcia Martiniano ;
Onofre de Lira, Antonio Carlos .
VASCULAR HEALTH AND RISK MANAGEMENT, 2016, 12 :491-496
[3]   Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients [J].
Cohen, Alexander T. ;
Harrington, Robert A. ;
Goldhaber, Samuel Z. ;
Hull, Russell D. ;
Wiens, Brian L. ;
Gold, Alex ;
Hernandez, Adrian F. ;
Gibson, C. Michael ;
Cohen, Alexander ;
Harrington, Robert ;
Gibson, C. Michael ;
Hull, Russell ;
Goldhaber, Samuel ;
Hernandez, Adrian ;
Ceresetto, Jose Manuel ;
Colquhoun, David ;
Pilger, Ernst ;
Polonetsky, Leonid ;
Motte, Serge ;
Saraiva, Jose Francisco ;
Raev, Dimitar ;
Mincheva, Valentina ;
Kahn, Susan ;
Canon, Claudia Olivares ;
Malojcic, Branko ;
Mayer, Otto ;
Husted, Steen ;
Marandi, Toomas ;
Lassila, Riitta ;
Mottier, Dominique ;
Shaburishvili, Tamaz ;
Bauersachs, Rupert ;
Zeymer, Uwe ;
Hajko, Erik ;
Zeltser, David ;
Ageno, Walter ;
Krievins, Dainis ;
Bagdonas, Alfredas ;
Osores, Juan Lema ;
Tomkowski, Witold ;
Mot, Stefan ;
Panchenko, Elizaveta ;
Tan, Ru San ;
Gaspar, Ludovit ;
Jacobson, Barry ;
Monreal, Manuel ;
Ongen, Gul ;
Parkhomenko, Alexander ;
Uprichard, James ;
Yusen, Roger .
NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (06) :534-544
[4]  
Cohen AT, 2013, NEW ENGL J MED, V368, P513, DOI 10.1056/NEJMoa1111096
[5]  
Cohoon KP, 2015, AM J MANAG CARE, V21, pE255
[6]   The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs [J].
Grosse, Scott D. ;
Nelson, Richard E. ;
Nyarko, Kwame A. ;
Richardson, Lisa C. ;
Raskob, Gary E. .
THROMBOSIS RESEARCH, 2016, 137 :3-10
[7]   Effect of a near-universal hospitalization-based prophylaxis regimen on annual number of venous thromboembolism events in the US [J].
Heit, John A. ;
Crusan, Daniel J. ;
Ashrani, Aneel A. ;
Petterson, Tanya M. ;
Bailey, Kent R. .
BLOOD, 2017, 130 (02) :109-114
[8]   Autophagy Protects Advanced Glycation End Product-Induced Apoptosis and Expression of MMP-3 and MMP-13 in Rat Chondrocytes [J].
Huang, Wenzhou ;
Ao, Peng ;
Li, Jian ;
Wu, Tianlong ;
Xu, Libiao ;
Deng, Zhongbo ;
Chen, Wenjie ;
Yin, Changchang ;
Cheng, Xigao .
BIOMED RESEARCH INTERNATIONAL, 2017, 2017
[9]   Prevention of VTE in Nonsurgical Patients Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [J].
Kahn, Susan R. ;
Lim, Wendy ;
Dunn, Andrew S. ;
Cushman, Mary ;
Dentali, Francesco ;
Akl, Elie A. ;
Cook, Deborah J. ;
Balekian, Alex A. ;
Klein, Russell C. ;
Le, Hoang ;
Schulman, Sam ;
Murad, M. Hassan .
CHEST, 2012, 141 (02) :E195S-E226S
[10]   ICD-9 Code-Based Venous Thromboembolism Performance Targets Fail to Measure Up [J].
Lau, Brandyn D. ;
Haut, Elliott R. ;
Hobson, Deborah B. ;
Kraus, Peggy S. ;
Maritim, Chepkorir ;
Austin, J. Matthew ;
Shermock, Kenneth M. ;
Maheshwari, Bhunesh ;
Allen, Paul X. ;
Almario, Aileen ;
Streiff, Michael B. .
AMERICAN JOURNAL OF MEDICAL QUALITY, 2016, 31 (05) :448-453