Kilgore Meredith, Patel Harshali K, Kielhorn Adrian, Maya Juan F, Sharma Pradeep
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Amgen, Inc., Thousand Oaks, CA, USA.
Risk Manag Healthc Policy. 2017 May 10;10:63-70. doi: 10.2147/RMHP.S130341. eCollection 2017.
The objective of this study was to assess the costs associated with the hospitalization and the cumulative 30-, 60-, and 90-day readmission rates in a cohort of Medicare beneficiaries with heart failure (HF).
This was a retrospective, observational study based on data from the national 5% sample of Medicare beneficiaries. Inpatient data were gathered for Medicare beneficiaries with at least one HF-related hospitalization between July 1, 2005, and December 31, 2011. The primary end point was the average per-patient cost of hospitalization for individuals with HF. Secondary end points included the cumulative rate of hospitalization, the average length of hospital stay, and the cumulative 30-, 60-, and 90-day readmission rates.
Data from 63,678 patients with a mean age of 81.8 years were included in the analysis. All costs were inflated to $2,015 based on the medical care component of the Consumer Price Index. The mean per-patient cost of an HF-related hospitalization was $14,631. The mean per-patient cost of a cardiovascular (CV)-related or all-cause hospitalization was $16,000 and $15,924, respectively. The cumulative rate of all-cause hospitalization was 218.8 admissions per 100 person-years, and the median length of stay for HF-related, CV-related, and all-cause hospitalizations was 5 days. Also, 22.3% of patients were readmitted within 30 days, 33.3% were readmitted within 60 days, and 40.2% were readmitted within 90 days.
The costs associated with hospitalization for Medicare beneficiaries with HF are substantial and are compounded by a high rate of readmission.
本研究的目的是评估一组患有心力衰竭（HF）的医疗保险受益人的住院费用以及30天、60天和90天的累计再入院率。
这是一项基于医疗保险受益人全国5%样本数据的回顾性观察研究。收集了2005年7月1日至2011年12月31日期间至少有一次与HF相关住院治疗的医疗保险受益人的住院数据。主要终点是HF患者的人均住院费用。次要终点包括累计住院率、平均住院时间以及30天、60天和90天的累计再入院率。
分析纳入了63678例平均年龄为81.8岁的患者的数据。根据消费者价格指数的医疗保健部分，所有费用均折算为2015美元。与HF相关的住院治疗的人均费用为14631美元。与心血管（CV）相关或全因住院治疗的人均费用分别为16000美元和15924美元。全因住院治疗的累计率为每100人年218.8次入院，与HF相关、CV相关和全因住院治疗的中位住院时间为5天。此外，22.3%的患者在30天内再次入院，33.3%的患者在60天内再次入院，40.2%的患者在90天内再次入院。
患有HF的医疗保险受益人的住院费用很高，而且再入院率很高，使情况更加复杂。
