Healthcare Utilization One Year Before Sudden Cardiac Death in Taiwan.

Abstract

Introduction: This study aimed to investigate the patterns of healthcare system utilization before sudden cardiac death in Taiwan and compare the patterns between patients treated at medical centers and noncenter hospitals.

Methods: This descriptive multicenter retrospective cohort study recruited adult, nontraumatic sudden cardiac death patients who were admitted to the National Taiwan University Hospital and its affiliated hospitals between January 2017 and December 2022. Healthcare utilization patterns, such as outpatient visits, emergency department visits, short-term emergency department returns, and hospitalizations, were analyzed during the weeks prior to SCD. The statistical analysis compared the above patterns between medical center and noncenter cohorts to identify potential differences in patient behavior and healthcare use.

Results: Analysis of 3,649 eligible patients revealed a significant increase in healthcare utilization before sudden cardiac death. Outpatient visits began to rise sharply 5 weeks prior to sudden cardiac death, peaking at 16.5% in the overall cohort. The number of emergency department visits showed a notable increase starting 10 weeks prior, with a peak in the week immediately before the sudden cardiac death, reaching 3.7%. Hospitalization rates exhibited a distinct pattern, peaking at 2.5% 3 weeks before sudden cardiac death and then declining. The consistency between hospitalization diagnoses and the cause of sudden cardiac death was approximately 40% within 3 weeks prior to sudden cardiac death. The increases were consistent across both the medical center and noncenter cohorts, although noncenter patients generally exhibited higher utilization rates.

Conclusions: Healthcare utilization significantly increased before sudden cardiac death, including outpatient visits, emergency department visits, and hospitalization. This pattern was consistent among patients treated at medical centers and nonmedical centers.