Abstract 18870: Not Just the Usual Suspects: Co-Morbid Drivers of Inpatient Costs in 620,728 Adults Admitted for Heart Failure.
Background: The cost associated with the treatment of heart failure (HF) approximates $40billion annually.
Purpose: The purpose of this study was to examine the associations between comorbidities and all-cause inpatient costs in adults admitted for HF.
Methods: We used a nationally-representative sample from the 2006 Agency for Healthcare Research and Quality (AHRQ) Health Care Utilization Project (HCUP) for this study of 620,728 adults (18 years or older) with a diagnosis of HF (CCS:108) within the top 3 reasons for admission to the hospital. Generalized linear modeling was used to assess all-cause inpatient costs, using the gamma family and log link, as a function of 28 AHRQ comorbidity measures. Inpatient costs were adjusted for demographics (age, gender, race, income, region), comorbidity severity (Deyo-Charlson index), hospital characteristics (bed size, region, rural vs. urban, teaching status), and primary and secondary payers. Results (reported as weighted estimates±standard errors): Mean age was 71.6±0.02 years; 53.2%±0.1% of the sample was female. The average inpatient cost was $10,615±16. The 10 most prevalent comorbid conditions (in estimated proportion) were hypertension (64.7%), uncomplicated diabetes (33.1%), chronic pulmonary disease (30.0%), renal failure (26.1%), fluid and electrolyte disorders (23.8%), deficiency anemias (19.2%), hypothyroidism (12.3%), obesity (10.2%), diabetes with chronic complications (8.4% ), and peripheral vascular disorders (7.2%). Of these common comorbidities, chronic pulmonary disease, fluid and electrolyte disorders, and renal failure were associated with 4.4%±0.4%, 7.3%±0.4%, and 3.9%±0.5% greater all-cause inpatient costs, respectively, holding other factors constant (all P<.001). In addition, coagulopathy and weight loss (both with 2.8% prevalence) were associated with, respectively, 6.9%±1.1% and 11.3%±1.1% greater inpatient costs (both P<.001).
Conclusions: We found strong associations between several common and less prevalent comorbidities and greater proportional inpatient costs in patients admitted for HF. Future research must focus on cost-driving comorbidities of adults admitted with HF, not just costs directly attributable to HF.
- © 2010 by American Heart Association, Inc.