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Temporal trends in healthcare resource utilization and costs following acute myocardial infarction

BACKGROUND: Acute myocardial infarction (AMI) is associated with greater utilization of healthcare resources and financial expenditure. OBJECTIVES: To evaluate temporal trends in healthcare resource utilization and costs following AMI throughout 2003–2015. METHODS: AMI patients who survived the firs...

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Autores principales: Shiyovich, Arthur, Gilutz, Harel, Arbelle, Jonathan Eli, Greenberg, Dan, Plakht, Ygal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017462/
https://www.ncbi.nlm.nih.gov/pubmed/32051030
http://dx.doi.org/10.1186/s13584-020-0364-y
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author Shiyovich, Arthur
Gilutz, Harel
Arbelle, Jonathan Eli
Greenberg, Dan
Plakht, Ygal
author_facet Shiyovich, Arthur
Gilutz, Harel
Arbelle, Jonathan Eli
Greenberg, Dan
Plakht, Ygal
author_sort Shiyovich, Arthur
collection PubMed
description BACKGROUND: Acute myocardial infarction (AMI) is associated with greater utilization of healthcare resources and financial expenditure. OBJECTIVES: To evaluate temporal trends in healthcare resource utilization and costs following AMI throughout 2003–2015. METHODS: AMI patients who survived the first year following hospitalization in a tertiary medical center (Soroka University Medical Center) throughout 2002–2012 were included and followed until 2015. Length of the in-hospital stay (LOS), emergency department (ED), primary care, outpatient consulting clinic visits and other ambulatory services, and their costs, were evaluated and compared annually over time. RESULTS: Overall 8047 patients qualified for the current study; mean age 65.0 (SD = 13.6) years, 30.3% women. During follow-up, LOS and the number of primary care visits has decreased significantly. However, ED and consultant visits as well as ambulatory-services utilization has increased. Total costs have decreased throughout this period. Multivariate analysis, adjusted for potential confounders, showed as significant trend of decrease in LOS and ambulatory-services utilization, yet an increase in ED visits with no change in total costs. CONCLUSIONS: Despite a decline in utilization of most healthcare services throughout the investigated decade, healthcare expenditure has not changed. Further evaluation of the cost-effectiveness of long-term resource allocation following AMI is warranted. Nevertheless, we believe more intense ambulatory follow-up focusing on secondary prevention and early detection, as well as high-quality outpatient chest pain unit are warranted.
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spelling pubmed-70174622020-02-20 Temporal trends in healthcare resource utilization and costs following acute myocardial infarction Shiyovich, Arthur Gilutz, Harel Arbelle, Jonathan Eli Greenberg, Dan Plakht, Ygal Isr J Health Policy Res Original Research Article BACKGROUND: Acute myocardial infarction (AMI) is associated with greater utilization of healthcare resources and financial expenditure. OBJECTIVES: To evaluate temporal trends in healthcare resource utilization and costs following AMI throughout 2003–2015. METHODS: AMI patients who survived the first year following hospitalization in a tertiary medical center (Soroka University Medical Center) throughout 2002–2012 were included and followed until 2015. Length of the in-hospital stay (LOS), emergency department (ED), primary care, outpatient consulting clinic visits and other ambulatory services, and their costs, were evaluated and compared annually over time. RESULTS: Overall 8047 patients qualified for the current study; mean age 65.0 (SD = 13.6) years, 30.3% women. During follow-up, LOS and the number of primary care visits has decreased significantly. However, ED and consultant visits as well as ambulatory-services utilization has increased. Total costs have decreased throughout this period. Multivariate analysis, adjusted for potential confounders, showed as significant trend of decrease in LOS and ambulatory-services utilization, yet an increase in ED visits with no change in total costs. CONCLUSIONS: Despite a decline in utilization of most healthcare services throughout the investigated decade, healthcare expenditure has not changed. Further evaluation of the cost-effectiveness of long-term resource allocation following AMI is warranted. Nevertheless, we believe more intense ambulatory follow-up focusing on secondary prevention and early detection, as well as high-quality outpatient chest pain unit are warranted. BioMed Central 2020-02-12 /pmc/articles/PMC7017462/ /pubmed/32051030 http://dx.doi.org/10.1186/s13584-020-0364-y Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research Article
Shiyovich, Arthur
Gilutz, Harel
Arbelle, Jonathan Eli
Greenberg, Dan
Plakht, Ygal
Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
title Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
title_full Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
title_fullStr Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
title_full_unstemmed Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
title_short Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
title_sort temporal trends in healthcare resource utilization and costs following acute myocardial infarction
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017462/
https://www.ncbi.nlm.nih.gov/pubmed/32051030
http://dx.doi.org/10.1186/s13584-020-0364-y
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