Abstract 20339: Healthcare Expenditure and Mortality Profile Associated With Acute Bacterial Endocarditis: Comparison Between Public and Private Health Systems
Introduction: Infective endocarditis (IE) yields a high in-hospital mortality rate despite appropriate management. Differences in patient & organizational factors in public & private hospitals may influence the outcome of IE patients. Additionally, there is significant healthcare expenditure due to ICU admissions, surgical intervention & extended regimens of antibiotic therapy. Few studies have quantified & analyzed outcomes & costs of managing IE in the Australian private and public healthcare systems.
Aim: To examine & compare the mortality profile & cost of managing public and private patients with IE.
Methods: Patient & costing data from St. Vincent’s Public & Private Hospitals, Melbourne, was retrospectively reviewed. Included patients met the modified Duke Criteria for definite or probable IE.
Results: 382 public patients & 107 private patients treated by the same clinicians in each setting, were included. Between 1999-2015, 70 (18.32%) public while 6 (10.91%) private patients died. Mean costs to treat IE was lower in the private system than the public system for both medical patients ($21254 vs. $51456, p<0.0001) & surgical patients ($37860 vs. $101850, p=0.0003). Previous valve surgery was a predictor of death in the private system (OR 2.2 [0.01, 4.46] p=0.05) while white cell count (OR 1.06 [1.01, 1.10] p=0.039), aortic valve IE (OR 2.89 [1.40, 5.98] p=0.004) & mitral valve IE (OR 2.53 [1.27, 5.02] p=0.008) were predictors of death in the public system. Cohort wide risk factors for mortality & relevant costing data are shown in Table 1.
Conclusion: There is a significant disparity in economic burden of IE between public and private systems. Hastening diagnosis & treatment by identifying factors associated with mortality in admitted patients may reduce ICU admissions, deaths & therefore health care expenditure in either health system. Further study on the interaction of IE with patient socioeconomic factors & institutional factors is warranted.
Author Disclosures: S. Paleri: None. J.J. Lovell: None. M. Peverelle: None. T. Lior: None. J. Darby: None. A. Newcomb: None. A. Wilson: None.
- © 2016 by American Heart Association, Inc.