Cargando…
Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both
BACKGROUND: The objective of this study was to determine the direct and indirect costs of acute coronary syndromes (ACS) alone and with common cardiovascular comorbidities. METHODS: A retrospective analysis was conducted using the Medical Expenditure Panel Survey from 1998 to 2009. Four mutually exc...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284047/ https://www.ncbi.nlm.nih.gov/pubmed/25565859 http://dx.doi.org/10.2147/VHRM.S72331 |
_version_ | 1782351366519259136 |
---|---|
author | Ghushchyan, Vahram Nair, Kavita V Page, Robert L |
author_facet | Ghushchyan, Vahram Nair, Kavita V Page, Robert L |
author_sort | Ghushchyan, Vahram |
collection | PubMed |
description | BACKGROUND: The objective of this study was to determine the direct and indirect costs of acute coronary syndromes (ACS) alone and with common cardiovascular comorbidities. METHODS: A retrospective analysis was conducted using the Medical Expenditure Panel Survey from 1998 to 2009. Four mutually exclusive cohorts were evaluated: ACS only, ACS with atrial fibrillation (AF), ACS with heart failure (HF), and ACS with both conditions. Direct costs were calculated for all-cause and cardiovascular-related health care resource utilization. Indirect costs were determined from productivity losses from missed days of work. Regression analysis was developed for each outcome controlling for age, US census region, insurance coverage, sex, race, ethnicity, education attainment, family income, and comorbidity burden. A negative binomial regression model was used for health care utilization variables. A Tobit model was utilized for health care costs and productivity loss variables. RESULTS: Total health care costs were greatest for those with ACS and both AF and HF ($38,484±5,191) followed by ACS with HF ($32,871±2,853), ACS with AF ($25,192±2,253), and ACS only ($17,954±563). Compared with the ACS only cohort, the mean all-cause adjusted health care costs associated with ACS with AF, ACS with HF, and ACS with AF and HF were $5,073 (95% confidence interval [CI] 719–9,427), $11,297 (95% CI 5,610–16,985), and $15,761 (95% CI 4,784–26,738) higher, respectively. Average wage losses associated with ACS with and without AF and/or HF amounted to $5,266 (95% CI −7,765, −2,767), when compared with patients without these conditions. CONCLUSION: ACS imposes a significant economic burden at both the individual and society level, particularly when with comorbid AF and HF. |
format | Online Article Text |
id | pubmed-4284047 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-42840472015-01-06 Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both Ghushchyan, Vahram Nair, Kavita V Page, Robert L Vasc Health Risk Manag Original Research BACKGROUND: The objective of this study was to determine the direct and indirect costs of acute coronary syndromes (ACS) alone and with common cardiovascular comorbidities. METHODS: A retrospective analysis was conducted using the Medical Expenditure Panel Survey from 1998 to 2009. Four mutually exclusive cohorts were evaluated: ACS only, ACS with atrial fibrillation (AF), ACS with heart failure (HF), and ACS with both conditions. Direct costs were calculated for all-cause and cardiovascular-related health care resource utilization. Indirect costs were determined from productivity losses from missed days of work. Regression analysis was developed for each outcome controlling for age, US census region, insurance coverage, sex, race, ethnicity, education attainment, family income, and comorbidity burden. A negative binomial regression model was used for health care utilization variables. A Tobit model was utilized for health care costs and productivity loss variables. RESULTS: Total health care costs were greatest for those with ACS and both AF and HF ($38,484±5,191) followed by ACS with HF ($32,871±2,853), ACS with AF ($25,192±2,253), and ACS only ($17,954±563). Compared with the ACS only cohort, the mean all-cause adjusted health care costs associated with ACS with AF, ACS with HF, and ACS with AF and HF were $5,073 (95% confidence interval [CI] 719–9,427), $11,297 (95% CI 5,610–16,985), and $15,761 (95% CI 4,784–26,738) higher, respectively. Average wage losses associated with ACS with and without AF and/or HF amounted to $5,266 (95% CI −7,765, −2,767), when compared with patients without these conditions. CONCLUSION: ACS imposes a significant economic burden at both the individual and society level, particularly when with comorbid AF and HF. Dove Medical Press 2014-12-24 /pmc/articles/PMC4284047/ /pubmed/25565859 http://dx.doi.org/10.2147/VHRM.S72331 Text en © 2015 Ghushchyan et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Ghushchyan, Vahram Nair, Kavita V Page, Robert L Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
title | Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
title_full | Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
title_fullStr | Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
title_full_unstemmed | Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
title_short | Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
title_sort | indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284047/ https://www.ncbi.nlm.nih.gov/pubmed/25565859 http://dx.doi.org/10.2147/VHRM.S72331 |
work_keys_str_mv | AT ghushchyanvahram indirectanddirectcostsofacutecoronarysyndromeswithcomorbidatrialfibrillationheartfailureorboth AT nairkavitav indirectanddirectcostsofacutecoronarysyndromeswithcomorbidatrialfibrillationheartfailureorboth AT pagerobertl indirectanddirectcostsofacutecoronarysyndromeswithcomorbidatrialfibrillationheartfailureorboth |