Bloom BS; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 61.
University of Pennsylvania, USA.
INTRODUCTION: Unstable angina pectoris (UA) is a complex complication of coronary artery disease (CAD), adding substantially to morbidity and cost of medical care. GOAL: To measure type and amount of resources used over two years in a defined population cohort diagnosed with unstable angina. METHOD: The population with anyone with a diagnosis of unstable angina during the previous 15 years. Care for UA during 1 July 1993 to 30 June 1995 for UA, other CAD and all other medical conditions were obtained from and integrated U.S. managed care organization (MCO). Cost per service was obtained from the Health Care Financing Administration. Outpatient pharmaceutical costs were obtained from the MCO. RESULTS: 406 persons were included in the study. Total medical costs for the study cohort during the two year period were $12,082,954; costs per person were $29,761 (S.D. $32,985), or $1,240 per month. UA accounted for 13.3% of cost, other CAD 48.1%, and all other diseases for 38.6% of total costs. Resource use during the study period was 3-fold higher for people who had diagnostic (e.g., cardiac catherization) or therapeutic (e.g., coronary artery bypass graft) procedures than for those who did not. Hospitalization costs accounted for 74.0% of the total; ambulatory care for 26.0%; outpatient pharmaceuticals accounted for 21.9% of ambulatory costs and 5.7% of total costs. Regression analysis found having any procedure, having any procedure, having myocardial infarction, and/or heart failure were the only variables significantly related to cost, R2=53.7%, p<0.0001. CONCLUSION: Patients with unstable angina pectoris incur substantial direct medical costs. While CAD costs contributed to the majority of expenses, non coronary diseases were responsible for more than one-third of total costs. Controlling ambulatory, especially pharmaceutical costs, can have onlysmall effect. Interventions that can reduce hospitalizations and procedures will have major economic implications.
Publication Types:
Keywords:
- Angina, Unstable
- Coronary Artery Bypass
- Coronary Artery Disease
- Coronary Disease
- Costs and Cost Analysis
- Health Expenditures
- Hospitalization
- Humans
- Myocardial Infarction
- Population
- Population Groups
- United States
- economics
- surgery
- hsrmtgs
Other ID:
UI: 102234713
From Meeting Abstracts