Cost of acute heart failure related readmissions

Czech version

Authors: B. Říhová ¹; J. Pařenica ²; R. Miklík ²; M. Felšöci ²; K. Hořáková ²; A. Šulcová ¹; J. Jarkovský ³; J. Špinar ²
Authors‘ workplace: Farmakologický ústav Lékařské fakulty MU Brno, přednostka MUDr. Regina Demlová, Ph. D. ¹; Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC ²; Institut biostatistiky a analýz Lékařské a Přírodovědecké fakulty MU Brno, vedoucí pracoviště doc. RNDr. Ladislav Dušek, Ph. D. ³
Published in: Vnitř Lék 2011; 57(10): 803-807
Category: Original Contributions

Overview

Aim of study:
To assess direct in-patient cost and length of stay in the intensive care unit (ICU) and the standard cardiology unit in acute heart failure (AHF) readmissions.

Results:
Out of 1 759 patients hospitalized with acute heart failure, 223 patients were readmitted to Faculty Hospital Brno-Bohunice (Czech Republic) during study period (61.4% male; mean age 71.2 years) with mean total cost CZK 85 120 (? 3 095) per length of stay 9.2 days and interventions. Comparing to the first hospitalization of study cohort (223 pts.) the decrease was recorded in mean room rate, length of stay and need of ICU stay (from 48% to 42% pts.), nevertheless ICU stay increased (from 3.7 days to 4.1 days). The growth of mean cost was recorded in both procedures in angiology (the decrease in number of coronary angiography which is cheaper was more remarkable than PCI decrease in readmitted patients) and arrhythmology (including device: pacemaker, ICD, CRT) which made 57.5% of total readmission costs.

Conclusion:
The difference in mean in-patient cost between the first and second hospitalization was 18%. The antiarrhytmic procedures had the most significant impact on total readmission cost and its variability, but we assume that these procedures will reduce within next readmissions and their impact will weaken as in angiology procedures.

Key words:
acute heart failure – pharmacoeconomics – in-hospital costs – hospital readmission

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