TY - JOUR
T1 - Healthcare-service utilization and direct costs throughout ten years following acute myocardial infarction
T2 - Soroka Acute Myocardial Infarction II (SAMI II) project
AU - Plakht, Ygal
AU - Gilutz, Harel
AU - Arbelle, Jonathan Eli
AU - Greenberg, Dan
AU - Shiyovich, Arthur
N1 - Publisher Copyright: © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/7/3
Y1 - 2019/7/3
N2 - Objective: Acute myocardial infarction (AMI) is associated with significant risk for long-term morbidity and healthcare expenditure. We investigated healthcare utilization and direct costs throughout 10 years following AMI. Methods: A retrospective study included AMI patients hospitalized in a tertiary medical center throughout 2002–2012. Data was obtained from computerized medical records. Hospitalizations, emergency department (ED), primary care and outpatient consulting clinic visits and other ambulatory services, following the AMI and their costs, were compared with the year preceding the AMI. Results: Overall 9548 patients were analyzed (age 66.6 ± 13.9 years, 67.8% men, 48.1% ST-elevation AMI). A significant increase in the utilization of all the evaluated services was observed in the first year following the AMI compared with the preceding year (p <.001 for each) and followed by a decline thereafter (p-for trend <.001 for each) except increased number of ED visits (p-for trend =.014). Annual per-patient costs throughout the first year following AMI (5592€) were significantly greater compared with the preceding year (3120€) and declined subsequently to 3216€ and 2760€ for years 2–5 and 6–10, respectively. Multivariate analysis showed that throughout the first half of the follow-up total costs were slightly higher and in the second half similar to the year preceding the AMI. Analysis of the relative costs showed that ambulatory services make up most of the expenditure. Conclusions: Healthcare utilization and economic expenditure peak throughout the first year and decline afterwards. For several services it remains higher for up to 10 years compared with the year preceding the AMI.
AB - Objective: Acute myocardial infarction (AMI) is associated with significant risk for long-term morbidity and healthcare expenditure. We investigated healthcare utilization and direct costs throughout 10 years following AMI. Methods: A retrospective study included AMI patients hospitalized in a tertiary medical center throughout 2002–2012. Data was obtained from computerized medical records. Hospitalizations, emergency department (ED), primary care and outpatient consulting clinic visits and other ambulatory services, following the AMI and their costs, were compared with the year preceding the AMI. Results: Overall 9548 patients were analyzed (age 66.6 ± 13.9 years, 67.8% men, 48.1% ST-elevation AMI). A significant increase in the utilization of all the evaluated services was observed in the first year following the AMI compared with the preceding year (p <.001 for each) and followed by a decline thereafter (p-for trend <.001 for each) except increased number of ED visits (p-for trend =.014). Annual per-patient costs throughout the first year following AMI (5592€) were significantly greater compared with the preceding year (3120€) and declined subsequently to 3216€ and 2760€ for years 2–5 and 6–10, respectively. Multivariate analysis showed that throughout the first half of the follow-up total costs were slightly higher and in the second half similar to the year preceding the AMI. Analysis of the relative costs showed that ambulatory services make up most of the expenditure. Conclusions: Healthcare utilization and economic expenditure peak throughout the first year and decline afterwards. For several services it remains higher for up to 10 years compared with the year preceding the AMI.
KW - Acute myocardial infarction
KW - direct cost
KW - follow-up study
KW - healthcare utilization
UR - http://www.scopus.com/inward/record.url?scp=85067365898&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/03007995.2019.1571298
DO - https://doi.org/10.1080/03007995.2019.1571298
M3 - Article
C2 - 30649969
SN - 0300-7995
VL - 35
SP - 1257
EP - 1263
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 7
ER -