Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, NY.
Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
J Arthroplasty. 2019 Dec;34(12):2846-2854.e2. doi: 10.1016/j.arth.2019.07.011. Epub 2019 Jul 12.
Investigations suggest a relationship between increased resource utilization with disease burden and advanced age. However, it remains unknown the degree increased resource utilization is associated with pre-existing conditions, before complications occur.
This retrospective study identified total hip/knee arthroplasty cases in the Premier Database from 2006 to 2016 (N = 1,613,744), with hospitalization cost as the primary outcome. With a variable combining the conditions and complication, generalized linear models measured associations between condition/complication interaction groups and hospitalization cost. Estimates of percent cost increase by variable were obtained.
Across all conditions, an increase in cost ranging from 0.38% to 4.28% was found in the absence of a complication. The "Condition = No, Complication = Yes" group was associated with a range of 11.50%-12.40% increase in average hospitalization cost, and the range was 14.43%-30.85% for the "Condition = Yes, Complication = Yes" group.
We found that having a high-risk condition without a complication accounted only for a modest hospitalization cost increase.
研究表明，资源利用率的增加与疾病负担和年龄增长有关。然而，在并发症发生之前，资源利用率与预先存在的疾病之间的关联程度仍不清楚。
本回顾性研究在 Premier 数据库中确定了 2006 年至 2016 年的全髋关节/膝关节置换术病例（N=1,613,744），以住院费用为主要结局。通过一个结合疾病和并发症的变量，广义线性模型测量了疾病/并发症交互组与住院费用之间的关联。通过变量获得了成本增加的百分比估计值。
在所有疾病中，在没有并发症的情况下，成本增加范围为 0.38%至 4.28%。“无疾病，有并发症”组的平均住院费用增加幅度在 11.50%-12.40%之间，而“有疾病，有并发症”组的平均住院费用增加幅度在 14.43%-30.85%之间。
我们发现，高风险疾病而没有并发症仅导致适度的住院费用增加。
