Bhandari Ruchi, Abdulhay Noor, Wiener R Constance, Smith Dalton, Fisher Melanie
School of Public Health, West Virginia University, Morgantown, USA.
School of Dentistry, West Virginia University, Morgantown, USA.
Epidemiol Infect. 2024 Dec 26;153:e9. doi: 10.1017/S0950268824001869.
The financial burden of hospitalization from life-threatening infectious diseases on the U.S. healthcare system is substantial and continues to increase. The purpose of this study was to identify key predictors of high hospital charges for infective endocarditis at a major university-affiliated cardiac care centre in West Virginia.A retrospective electronic medical records' review was undertaken of all adult patients admitted for endocarditis between 2014-2018. Multiple linear regression analysis assessed the total charges billed to the patient account for their endocarditis hospitalization in the medical record.Hospital charges have increased 12-fold during 2014-2018. Among the 486 patients, the median hospital charge was $198 678. About 47% of the patients underwent surgery incurring 70% of the total charges. Patients with hospital stays of ≥50 days accounted for a third of all charges. The multiple linear regression model accounted for 85% of the linear variance in the hospital charges. Median charges increased by 30.87% for patients with ≥9 consultations, 60.32% for those who died in the hospital, and 81.85% for those who underwent surgical intervention.The study findings showed that complex care requiring multiple consultations, surgical interventions, and longer hospital stays were significantly associated with higher hospital charges for endocarditis treatment.
危及生命的传染病导致的住院治疗给美国医疗系统带来的经济负担巨大且持续增加。本研究的目的是在西弗吉尼亚州一所主要的大学附属心脏护理中心，确定感染性心内膜炎高额住院费用的关键预测因素。
对2014年至2018年间因心内膜炎入院的所有成年患者进行了回顾性电子病历审查。多元线性回归分析评估了病历中患者因心内膜炎住院的总费用。
2014年至2018年间，住院费用增长了12倍。在486名患者中，住院费用中位数为198,678美元。约47%的患者接受了手术，手术费用占总费用的70%。住院时间≥50天的患者费用占总费用的三分之一。多元线性回归模型解释了住院费用中85%的线性方差。会诊次数≥9次的患者，费用中位数增加30.87%；在医院死亡的患者，费用中位数增加60.32%；接受手术干预的患者，费用中位数增加81.85%。
研究结果表明，需要多次会诊、手术干预和更长住院时间的复杂护理与感染性心内膜炎治疗的高额住院费用显著相关。
