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Relationship of hospital-associated bleeding with length of stay and total hospitalization costs in patients hospitalized for atrial fibrillation.
J Med Econ. 2015 Dec 25;:1-25
Authors: Amin AN, Robinson SB, Bowdy BD, Jing Y, Johnson BH, Wiederkehr DP
Abstract
BACKGROUND: While literature has focused on the impact of bleeding beginning outside the hospital setting among patients with atrial fibrillation (AF), there is little information regarding bleeding that first occurs within a hospital setting. This study was performed to determine the association between hospital associated bleeding in patients admitted for AF on outcomes of length of stay (LOS) and total hospitalization cost.
METHODS AND RESULTS: The Premier research database was queried to identify adult inpatients discharged between 2008 and 2011 having a primary diagnosis code for AF where a bleeding diagnosis code was not present on admission. Regression was used to adjust for baseline differences in patients to estimate outcomes comparing patients with and without a hospital associated bleed. There were 143,287 patients that met the study criteria. There were 2,991 (2.1%) patients identified with a hospital associated bleed. After adjustment for covariates, the mean estimated LOS was significantly greater in the bleed group 6.0 days (95% CI 5.8-6.1) versus the no bleed group 3.3 days (95% CI 3.3-3.3) (p < 0.0001). Similarly, the adjusted mean estimated total hospitalization cost was also significantly greater in the bleed group $12,069 (95% CI $11,779-$12,366) vs. $6,561 (95% CI $6,538-$6,583) in the no bleed group (p < 0.0001).
CONCLUSIONS: After adjustments for baseline differences the data show that the 2.1% (n=2,991) of patients with hospital associated bleeding accounted for an estimated additional 8,106 hospitalization days and $16.4 million dollars in cost over the study period compared to non-bleeders.
PMID: 26705579 [PubMed - as supplied by publisher]