Marya D Zilberberg, Brian H Nathanson, Katherine Sulham, John F Mohr, Matthew M Goodwin, Andrew F Shorr
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We applied complex survey methods to calculate nationally representative results.</p><p><strong>Results: </strong>Among 4,979,350 discharges with any CHF code, 1,177,910 (23.7%) had CHF-PD, of whom 511,555 (43.4%) had SLOS. Patients with SLOS were younger (>/=65 years: 68.3% vs 71.9%), less likely covered by Medicare (71.9% vs 75.4%), and had a lower comorbidity burden (Charlson: 3.9 [2.1] vs 4.5 [2.2) than patients with LLOS; they less frequently developed acute kidney injury (0.4% vs 2.9%) or a need for mechanical ventilation (0.7% vs 2.8%). A higher proportion with SLOS than with LLOS underwent no procedures (70.4% vs 48.4%). Mean LOS (2.2 [0.8] vs 7.7 [6.5]), direct hospital costs ($6150 [$4413]) vs $17,127 [$26,936]), and aggregate annual hospital costs $3,131,560,372 vs $11,359,002,072) were all lower with SLOS than LLOS. All comparisons reached alpha = 0.001.</p><p><strong>Conclusion: </strong>Among patients admitted for CHF, nearly ½ have LOS </=3 days, and almost ¾ of them requires no inpatient procedures. A more aggressive outpatient heart failure management strategy may allow many patients to avoid hospitalizations and their potential complications and costs.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/8d/ceor-15-139.PMC9975205.pdf","citationCount":"2","resultStr":"{\"title\":\"Descriptive Epidemiology and Outcomes of Patients with Short Stay Hospitalizations for the Treatment of Congestive Heart Failure in the US.\",\"authors\":\"Marya D Zilberberg, Brian H Nathanson, Katherine Sulham, John F Mohr, Matthew M Goodwin, Andrew F Shorr\",\"doi\":\"10.2147/CEOR.S400882\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Congestive heart failure (CHF) hospitalizations cost the US $35 billion annually. Two-thirds of these admissions, generally requiring </=3 days in the hospital, are solely for the purpose of diuresis, and may be avoidable.</p><p><strong>Methods: </strong>Among patients discharged with CHF as the principal diagnosis (PD), we compared characteristics and outcomes between those with hospital length of stay (LOS) </=3 days (short, SLOS) and >3 days (long, LLOS) in a cross-sectional multicenter analysis within the 2018 National Inpatient Sample. We applied complex survey methods to calculate nationally representative results.</p><p><strong>Results: </strong>Among 4,979,350 discharges with any CHF code, 1,177,910 (23.7%) had CHF-PD, of whom 511,555 (43.4%) had SLOS. Patients with SLOS were younger (>/=65 years: 68.3% vs 71.9%), less likely covered by Medicare (71.9% vs 75.4%), and had a lower comorbidity burden (Charlson: 3.9 [2.1] vs 4.5 [2.2) than patients with LLOS; they less frequently developed acute kidney injury (0.4% vs 2.9%) or a need for mechanical ventilation (0.7% vs 2.8%). A higher proportion with SLOS than with LLOS underwent no procedures (70.4% vs 48.4%). Mean LOS (2.2 [0.8] vs 7.7 [6.5]), direct hospital costs ($6150 [$4413]) vs $17,127 [$26,936]), and aggregate annual hospital costs $3,131,560,372 vs $11,359,002,072) were all lower with SLOS than LLOS. All comparisons reached alpha = 0.001.</p><p><strong>Conclusion: </strong>Among patients admitted for CHF, nearly ½ have LOS </=3 days, and almost ¾ of them requires no inpatient procedures. A more aggressive outpatient heart failure management strategy may allow many patients to avoid hospitalizations and their potential complications and costs.</p>\",\"PeriodicalId\":47313,\"journal\":{\"name\":\"ClinicoEconomics and Outcomes Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/8d/ceor-15-139.PMC9975205.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ClinicoEconomics and Outcomes Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/CEOR.S400882\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ClinicoEconomics and Outcomes Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/CEOR.S400882","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 2
摘要
背景:充血性心力衰竭(CHF)住院治疗每年花费350亿美元。在以CHF为主要诊断(PD)出院的患者中，我们在2018年全国住院患者样本的横断面多中心分析中比较了住院时间(LOS)为3天(长，LLOS)的患者的特征和结局。我们采用复杂的调查方法来计算具有全国代表性的结果。结果:在所有CHF代码的4,979,350例出院患者中，1,177,910例(23.7%)发生CHF- pd，其中511,555例(43.4%)发生sls。与LLOS患者相比，sls患者更年轻(>/=65岁:68.3%对71.9%)，更不可能被医疗保险覆盖(71.9%对75.4%)，并且具有更低的共病负担(Charlson: 3.9[2.1]对4.5 [2.2);他们较少发生急性肾损伤(0.4%对2.9%)或需要机械通气(0.7%对2.8%)。SLOS患者比LLOS患者未接受手术的比例更高(70.4% vs 48.4%)。平均LOS (2.2 [0.8] vs 7.7[6.5])、直接住院费用(6150[4413]美元vs 17,127[26,936]美元)、年度总住院费用(3,131,560,372美元vs 11,359,002,072美元)均低于LLOS。所有比较均达到α = 0.001。结论:在因CHF入院的患者中，近一半的患者有LOS
Descriptive Epidemiology and Outcomes of Patients with Short Stay Hospitalizations for the Treatment of Congestive Heart Failure in the US.
Background: Congestive heart failure (CHF) hospitalizations cost the US $35 billion annually. Two-thirds of these admissions, generally requiring
Methods: Among patients discharged with CHF as the principal diagnosis (PD), we compared characteristics and outcomes between those with hospital length of stay (LOS) 3 days (long, LLOS) in a cross-sectional multicenter analysis within the 2018 National Inpatient Sample. We applied complex survey methods to calculate nationally representative results.
Results: Among 4,979,350 discharges with any CHF code, 1,177,910 (23.7%) had CHF-PD, of whom 511,555 (43.4%) had SLOS. Patients with SLOS were younger (>/=65 years: 68.3% vs 71.9%), less likely covered by Medicare (71.9% vs 75.4%), and had a lower comorbidity burden (Charlson: 3.9 [2.1] vs 4.5 [2.2) than patients with LLOS; they less frequently developed acute kidney injury (0.4% vs 2.9%) or a need for mechanical ventilation (0.7% vs 2.8%). A higher proportion with SLOS than with LLOS underwent no procedures (70.4% vs 48.4%). Mean LOS (2.2 [0.8] vs 7.7 [6.5]), direct hospital costs ($6150 [$4413]) vs $17,127 [$26,936]), and aggregate annual hospital costs $3,131,560,372 vs $11,359,002,072) were all lower with SLOS than LLOS. All comparisons reached alpha = 0.001.
Conclusion: Among patients admitted for CHF, nearly ½ have LOS
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