Economic and Health Care Resource Utilization (HCRU) Burden of Acute Myocardial Infarction (AMI) With or Without Systemic Inflammation in US Hospitals: A Real-World Study
Author(s)
Lei Lv, MPH, PhD1, Jeffrey Skaar, PhD2, Carey Robar, PhD3, Sunday Ikpe, PhD4, Shanthi Krishnaswami, MPH4, Zhun Cao, PhD4, Weilong Li, PhD2, Michael Nanna, MD, MHS, FSCAI, FACC5.
1Post-Doc Fellow, Novo Nordisk, Plainsboro Township, NJ, USA, 2Novo Nordisk Inc, Plainsboro, NJ, USA, 3Novo Nordisk, Plainsboro, NJ, USA, 4Premier Inc, Charlotte, NC, USA, 5Yale School of Medicine, New Haven, CT, USA.
1Post-Doc Fellow, Novo Nordisk, Plainsboro Township, NJ, USA, 2Novo Nordisk Inc, Plainsboro, NJ, USA, 3Novo Nordisk, Plainsboro, NJ, USA, 4Premier Inc, Charlotte, NC, USA, 5Yale School of Medicine, New Haven, CT, USA.
Presentation Documents
OBJECTIVES: Annually in the US, ~605,000 people experience an AMI. This study evaluated cost and HCRU of patients hospitalized for AMI with or without evidence of systemic inflammation before hospitalization.
METHODS: Patients aged ≥18 years with an AMI-related hospitalization by International Classification of Diseases coding were identified from the PINC AITM Healthcare Database (01/01/2017-08/31/2023). A subcohort with systemic inflammation was defined by high-sensitivity C-reactive protein (hsCRP)/CRP levels 2-10 mg/L. Cost and HCRU during initial admission (index) and 30- and 90-day readmissions post-index were assessed.
RESULTS: In the total cohort (N=1,078,572), the mean (SD) age was 67.0 (13.6) years, admission through the emergency room (ER) was most common (78.5%), and most patients were male (60.9%). The mean index cost was $23,648 ($23,648). The mean total inpatient cost across all visits (n=1,073,698) was $50,172 ($49,128). Compared with patients without systemic inflammation (n=1,076,899), patients with systemic inflammation (n=1673) were more likely to be admitted via the ER (91.2% vs 78.5%), stayed longer (5.2 [5.1] vs 4.9 [5.0] days), and had higher median (IQR) outpatient visit costs ($1192 [$417-$3784] vs $1109 [$345-$3352]) (all P<0.01). Within 30 and 90 days of index discharge, patients with systemic inflammation had higher readmission rates (30 days: 13.0% vs 7.3%; 90 days: 22.0% vs 12.0%) and more outpatient (30 days: 2.0 [1.5] vs 1.5 [1.1]; 90 days: 3.7 [3.9] vs 2.4 [2.9]) and ER visits (30 days: 1.3 [0.9] vs 1.2 [0.5]; 90 days: 1.8 [1.6] vs 1.4 [0.9]) (all P<0.01). Within 90 days of discharge, patients with systemic inflammation had higher stroke/AMI-related readmission rates (19.5% vs 10.8%) and longer stroke/AMI-related hospital stays (7.3 [7.2] vs 6.4 [6.5] days) (all P<0.01).
CONCLUSIONS: This study details the persistently high cost and HCRU of patients hospitalized for AMI. In exploratory analyses, cost and HCRU were significantly higher among patients with systemic inflammation.
METHODS: Patients aged ≥18 years with an AMI-related hospitalization by International Classification of Diseases coding were identified from the PINC AITM Healthcare Database (01/01/2017-08/31/2023). A subcohort with systemic inflammation was defined by high-sensitivity C-reactive protein (hsCRP)/CRP levels 2-10 mg/L. Cost and HCRU during initial admission (index) and 30- and 90-day readmissions post-index were assessed.
RESULTS: In the total cohort (N=1,078,572), the mean (SD) age was 67.0 (13.6) years, admission through the emergency room (ER) was most common (78.5%), and most patients were male (60.9%). The mean index cost was $23,648 ($23,648). The mean total inpatient cost across all visits (n=1,073,698) was $50,172 ($49,128). Compared with patients without systemic inflammation (n=1,076,899), patients with systemic inflammation (n=1673) were more likely to be admitted via the ER (91.2% vs 78.5%), stayed longer (5.2 [5.1] vs 4.9 [5.0] days), and had higher median (IQR) outpatient visit costs ($1192 [$417-$3784] vs $1109 [$345-$3352]) (all P<0.01). Within 30 and 90 days of index discharge, patients with systemic inflammation had higher readmission rates (30 days: 13.0% vs 7.3%; 90 days: 22.0% vs 12.0%) and more outpatient (30 days: 2.0 [1.5] vs 1.5 [1.1]; 90 days: 3.7 [3.9] vs 2.4 [2.9]) and ER visits (30 days: 1.3 [0.9] vs 1.2 [0.5]; 90 days: 1.8 [1.6] vs 1.4 [0.9]) (all P<0.01). Within 90 days of discharge, patients with systemic inflammation had higher stroke/AMI-related readmission rates (19.5% vs 10.8%) and longer stroke/AMI-related hospital stays (7.3 [7.2] vs 6.4 [6.5] days) (all P<0.01).
CONCLUSIONS: This study details the persistently high cost and HCRU of patients hospitalized for AMI. In exploratory analyses, cost and HCRU were significantly higher among patients with systemic inflammation.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD121
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)