Background:
Cardiovascular (CV) disease is the leading cause of mortality in both men and women in the US, resulting in substantial health care utilization and costs. There are limited data quantifying long-term resource utilization following an ACS event.
Objectives:
Evaluate overall and CV-related health care utilization following an ACS event in patients with/without recurrent CV events (CVEs) post-discharge.
Methods:
Patients with ≥1 ICD-9 CM code for acute myocardial infarction MI) (410.xx) or unstable angina (411.1x) during ACS hospitalization were identified from the HealthCore Integrated Research Database 01/01/2006-09/30/2011. Index date was defined as the first ACS event. Patients with <12 months’ pre-/post-index plan eligibility or age <18 years were excluded. Recurrent CVEs were defined as any occurrence of MI, non-fatal stroke or coronary heart disease-related mortality after the index ACS event. Overall and CV-related health care resource utilization following the index ACS event were evaluated in patients with/without recurrent CVEs.
Results:
Of 140,903 patients, 22.0% had ≥1 subsequent CVE during follow-up. Patients with/without recurrent CVEs were older (mean 72.4 vs. 65.2 years) and had more comorbidities (mean baseline Deyo-Charlson Index scores 2.4 vs. 1.6). Mean (median) follow up was 2.0 (1.6) and 1.9 (1.5) years in patients with/without recurrent CVEs, respectively. Mean (median) number of 1-year post-index overall and CV-related hospitalizations in the recurrent CVE cohort was higher than the non-recurrent cohort (2.81 [1.98] and 2.40 [1.54] vs. 1.56 [1.23] and 1.30 [0.82], respectively). Mean number of 1-year post-index overall outpatient and office visits were higher in the recurrent versus non-recurrent cohort (31.82 [36.63] and 14.72 [11.15] vs. 21.65 [25.68] and 11.89 [9.67]). Mean annual 3-year utilization post-index showed the same trend (Table).
Conclusion:
Patients with recurrent CVEs had higher 1- and 3-year post-index overall and CV-related utilization as compared with patients without recurrent CVEs. More aggressive strategies to manage this increased long-term utilization is warranted. This study underscores the need to prevent subsequent adverse CVEs, ultimately to improve patient outcomes and help reduce overall health care utilization.
Health Care Resource Utilization and Costs Among Diabetes Patients Residing in long-Term Care Facilities
