HEALTHCARE RESOURCE UTILIZATION AND COSTS ASSOCIATED WITH SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE AND CHRONIC KIDNEY DISEASE: A RETROSPECTIVE COHORT STUDY
Author(s)
Danqing Qian, MPA1, MIN HU, PhD2;
1Fudan University, Shanghai, China, 2Fudan University, Professor, Shanghai, China
1Fudan University, Shanghai, China, 2Fudan University, Professor, Shanghai, China
OBJECTIVES: To evaluate the association of systemic inflammation (SI) with healthcare resource utilization (HCRU) and direct medical costs in patients with coronary heart dis-ease (CHD) and stage 3-4 chronic kidney disease (CKD).
METHODS: In this retrospective cohort study, we analyzed electronic medical records of adults hospitalized in 2023 at a tertiary hospital in Beijing, China, with confirmed CHD and stage 3-4 CKD. Patients were classified into SI (hsCRP >2 mg/L) or non-SI (hsCRP ≤2 mg/L) groups and followed for 12 months. HCRU outcomes were analyzed using negative binomial regression, and direct medical costs using a Heckman selection model.
RESULTS: Among 200 included patients (SI: n=112; non-SI: n=88), SI was associated with significantly increased all-cause HCRU, including higher annual total visits (IRR=1.46; 95% CI 1.05-2.04) and outpatient visits (IRR=1.52; 95% CI 1.01-2.28), as well as longer length of stay per admission (IRR=1.45; 95% CI 1.10-1.91). Cardiovascu-lar-specific HCRU was even more pronounced, with IRR of 4.22 (95% CI 1.01-17.66) for annual total visits and 4.73 (95% CI 1.01-22.23) for hospitalizations. Correspond-ingly, the SI group incurred significantly higher annual medical costs for both all-cause (¥92,563 vs. ¥34,849; p<0.001) and cardiovascular-specific costs (¥12,264 vs. ¥1,263; p=0.002). Treating hsCRP as a continuous variable, each 1 mg/L increase was associated with an increase in all-cause annual total costs (¥802.99; p<0.001).
CONCLUSIONS: In patients with CHD and CKD, systemic inflammation is strongly as-sociated with substantially increased healthcare resource utilization and direct medical costs. Our findings quantify this burden, showing near tripling of all-cause costs and a more than fourfold increase in cardiovascular-specific resource use. These results un-derscore the potential economic and clinical benefits of evaluating inflammation-targeted strategies in this high-risk population.
METHODS: In this retrospective cohort study, we analyzed electronic medical records of adults hospitalized in 2023 at a tertiary hospital in Beijing, China, with confirmed CHD and stage 3-4 CKD. Patients were classified into SI (hsCRP >2 mg/L) or non-SI (hsCRP ≤2 mg/L) groups and followed for 12 months. HCRU outcomes were analyzed using negative binomial regression, and direct medical costs using a Heckman selection model.
RESULTS: Among 200 included patients (SI: n=112; non-SI: n=88), SI was associated with significantly increased all-cause HCRU, including higher annual total visits (IRR=1.46; 95% CI 1.05-2.04) and outpatient visits (IRR=1.52; 95% CI 1.01-2.28), as well as longer length of stay per admission (IRR=1.45; 95% CI 1.10-1.91). Cardiovascu-lar-specific HCRU was even more pronounced, with IRR of 4.22 (95% CI 1.01-17.66) for annual total visits and 4.73 (95% CI 1.01-22.23) for hospitalizations. Correspond-ingly, the SI group incurred significantly higher annual medical costs for both all-cause (¥92,563 vs. ¥34,849; p<0.001) and cardiovascular-specific costs (¥12,264 vs. ¥1,263; p=0.002). Treating hsCRP as a continuous variable, each 1 mg/L increase was associated with an increase in all-cause annual total costs (¥802.99; p<0.001).
CONCLUSIONS: In patients with CHD and CKD, systemic inflammation is strongly as-sociated with substantially increased healthcare resource utilization and direct medical costs. Our findings quantify this burden, showing near tripling of all-cause costs and a more than fourfold increase in cardiovascular-specific resource use. These results un-derscore the potential economic and clinical benefits of evaluating inflammation-targeted strategies in this high-risk population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE216
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)