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Determinants of Costs and the Length of Stay in Acute Coronary Syndromes: A Real Life Analysis of More Than 10 000 Patients

Bramkamp, Matthias ; Radovanovic, Dragana ; Erne, Paul ; Szucs, Thomas

In: Cardiovascular Drugs and Therapy, 2007, vol. 21, no. 5, p. 389-398

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    Titre
    • Determinants of Costs and the Length of Stay in Acute Coronary Syndromes: A Real Life Analysis of More Than 10 000 Patients
    Auteur
    • Bramkamp, Matthias. Department of Internal Medicine, University Hospital of Zurich, RAE B 40, Rämistr. 100, CH-8091, Zurich, Switzerland
    • Radovanovic, Dragana. AMIS Plus Data Center, Institute for Social and Preventive Medicine, University of Zurich, Hirschgraben 84, CH-8001, Zürich, Switzerland
    • Erne, Paul. Department of Cardiology, Kantonsspital Lucerne, 6000, Lucerne 16, Switzerland
    • Szucs, Thomas. Institute for Social and Preventive Medicine, University of Zurich, Hirschgraben 84, CH-8001, Zürich, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Cardiovascular Drugs and Therapy, 2007, vol. 21, no. 5, p. 389-398. Springer US; http://www.springer-ny.com
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321859
    Summary
    Aims: The aim of this study was to investigate inpatient costs of acute coronary syndromes (ACS) in Switzerland and to assess the main cost drivers associated with this disease. Methods and Results: We used the national multicenter registry AMIS (acute myocardial infarction in Switzerland) which includes a representative number of 65 hospitals and a total of 11.623 patient records. The following cost modules were analyzed: hospital stay, percutaneous coronary interventions (PCI) and thrombolysis. Expenses were assessed using data from official Swiss national statistical sources. Mean total costs per patient were 12.101 Euro (median 10.929 Euro; 95% CI: 1.161-27.722 Euro). The length of stay ranged from one to 129days with a mean of 9.5days (median 8.0days; 95% CI: 1-23). Overall costs were independently influenced by age, gender and existent co-morbidities, e.g. cerebrovascular disease and diabetes (p < 0.0001). Conclusion: Our study determined specific causes for the high costs associated with hospital treatment on a large representative sample. The results should highlight unnecessary expenses and help policy makers to evaluate the base case for a DRG (Diagnosis Related Groups) scenario in Switzerland. Cost weighting of the identified secondary diagnosis should be considered in the calculation and coding of a primary diagnosis for ACS