COST AND QUALITY OF DYING IN HOSPITAL- RESULTS FROM THE ARGENTINE-HEALTH CARE COST AND UTILIZATION PROJECT (A-HCUP)

Author(s)

Insua JT*1;Villalon R1;Giunta D2, Ioli P3 1Hospital Universitario Austral, Universidad Austral, Derqui, Argentina, 2Hospital Italiando de Buenos Aires, Caba, Argentina, 3Hospital Privado de la Comunidad, Fundacion Medica de Mar del Plata, Mar del Plata, B

OBJECTIVES: Little is known about dying in Argentina, we studied costs and readmissions (ReH) <30 days of hospital dying adults. METHODS: A cross sectional study of 1 year hospital discharges, with HCUPs methods (Value in Health;14 (2011):A18), of patients ≥19 yrs old. We obtained deaths, first admission (1 adm) and ReH ≤365 days and ReH <30 days; total direct medical cost  (TC I$), mean (I$) (SD), median I$ (Q1-Q3) discharge cost, (in I$ PPP, 2008), stratified by age/sex, admissions and ReH <30 days and <365 days.  RESULTS: Total mortality for ≥19 yrs old patients was 4,70%. Among 2137 deaths, Total cost of those dead in hospital, TC I$: 40 540 842 ; mean cost per discharge (I$) was 19853 (SD 45 599); Median cost per discharge I$ 4182; (Q1: 1452-Q3: 17730 I$), comprising 8,31 % of TC I$.  Among 43321 discharges, TC$ of those alive, TC: 447 300 754 I$; mean cost per discharge ($) was 10569 I$ (SD 21 217); Median cost per discharge 14 091 I$; (Q1: 2 496- Q3:10 054 I$). Relative dead /alive I$ was 1,88 times higher. Mean discharge cost of deceased stratified by age group (mortality 19-64 yrs. old: 1,52%, I$ 48332, age 19-64/≥19 yrs old ratio: 2,43; 65-74 yrs old: 4,72%,I$ 25968, age ratio: 1,31; 75-84 yrs old: 8,45%; I$ 15471, age ratio: 0,78; 85+ yrs old: 14,09%, I$ 7832, age ratio: 0,39), and sex, males (47,4%) had a I$: 22679 (M/F I$ ratio: 1,45). In 1 adm.(53% of deaths), mean cost was I$ 23 792; while ReH ≤365 days (47% of deaths), I$ 13 530, cost ratio ReH/1 adm= 0,57 ; and if ReH <30 days (29,5%), I$ 12354, cost ratio ReH<30/1 adm=0,52. CONCLUSIONS: Understanding the economic burden of dying helps promote better and cost-effective ways of promoting palliative care, old and readmitted deaths are less costly.

Conference/Value in Health Info

2013-09, ISPOR Latin America 2013, Buenos Aires, Argentina

Value in Health, Vol. 16, No. 7 (November 2013)

Code

PHP55

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Quality of Care Measurement

Disease

Multiple Diseases

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