急性心肌梗死后死亡的高昂代价：来自美国国家医院数据库的结果。
The High Cost of Death After Acute Myocardial Infarctions: Results from a National US Hospital Database.
作者信息
Mallow Peter J, Browne Frederick, Shemisa Kamal
机构信息
Health Services Administration, Xavier University, Cincinnati, OH, USA.
TriHealth Heart Institute, Cincinnati, OH, USA.
出版信息
Clinicoecon Outcomes Res. 2023 Jan 31;15:63-68. doi: 10.2147/CEOR.S397220. eCollection 2023.
INTRODUCTION
This study described the differences in costs and length of stay (LOS) among patients with AMI who died versus survived using a large, nationally representative cohort of AMI patients.
METHODS
The 2019 HCUP NIS was used to analyze costs, and LOS among all patients with a principal diagnosis of AMI. A propensity-score matched analysis and multivariable regression were used to adjust for patient and hospital characteristics.
RESULTS
There were 4559 visits in each of the cohorts (total 9118). The adjusted mean hospital cost was $18,970 (95% CI $16,453 - $21,871) for those that survived and $23,173 (95% CI $20,167 - $26,626; p <0.001) for those that died. The LOS was 3.95 (95% CI 3.41-4.57) in survivors and 4.24 (95% CI 3.67-4.89; p <0.001) in those who died.
CONCLUSION
Survivors of AMI incurred lower costs and length of stay than those who died. Higher costs were attributed to greater LOS and higher-level care. The results suggest that economic evaluations of cardiovascular interventions that do not include the cost of dying may underestimate the benefits of the intervention.
引言
本研究使用一个具有全国代表性的大型急性心肌梗死（AMI）患者队列，描述了死亡与存活的AMI患者在成本和住院时间（LOS）方面的差异。
方法
使用2019年医疗成本和利用项目国家住院样本（HCUP NIS）分析所有主要诊断为AMI的患者的成本和住院时间。采用倾向得分匹配分析和多变量回归来调整患者和医院特征。
结果
每个队列中有4559次就诊（总计9118次）。存活患者的调整后平均住院成本为18,970美元（95%置信区间为16,453美元至21,871美元），死亡患者为23,173美元（95%置信区间为20,167美元至26,626美元；p<0.001）。存活者的住院时间为3.95天（95%置信区间为3.41 - 4.57天），死亡者为4.24天（95%置信区间为3.67 - 4.89天；p<0.
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