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Impact of type 2 diabetes mellitus on hospitalization costs in older patients with acute myocardial infarction.

Fu KL, Fan GQ, Han L, Wang XZ, Wang J, Wang YS, Zhong M, Zhang Y, Zhang W, Wang ZH - Clin Interv Aging (2014)

Bottom Line: Stenting was an important factor affecting older patients' total hospitalization costs (β=0.685, P=0.000) and treatment costs during the follow-up period (duration of hospital stay only, β=0.508, P=0.000).Stenting was a protective factor for preventing acute HF in the elderly during the follow-up period.From the perspective of reducing the incidence of acute HF in inpatients, implementation of percutaneous coronary intervention after an acute MI is more cost-effective in older patients with diabetes mellitus than in those without it.

View Article: PubMed Central - PubMed

Affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.

ABSTRACT

Background: The purpose of this study was to evaluate the impact of type 2 diabetes mellitus on hospitalization costs in older patients with acute myocardial infarction (MI).

Methods: Retrospective analysis of data from the case retrieval system of Qilu Hospital of Shandong University located in Jinan city of Shandong Province was done for patients with acute MI from January 1, 2011 to December 31, 2012.

Results: Stenting was an important factor affecting older patients' total hospitalization costs (β=0.685, P=0.000) and treatment costs during the follow-up period (duration of hospital stay only, β=0.508, P=0.000). Stenting was also a protective factor in the prevention of acute heart failure (HF) in older patients with acute MI during the follow-up period (odds ratio 0.189, 95% confidence interval 0.059-0.602, P=0.005). Implementation of percutaneous coronary intervention reduced the incidence of acute HF in older inpatients with acute MI (27.8% versus 4.3%, P=0.001) and without diabetes (18.2% versus 3.8%, P=0.001). Moreover, among the elderly, the incremental cost-effectiveness ratio estimate for implementing percutaneous coronary intervention in diabetic patients was higher than in nondiabetic patients.

Conclusion: Stenting was a protective factor for preventing acute HF in the elderly during the follow-up period. From the perspective of reducing the incidence of acute HF in inpatients, implementation of percutaneous coronary intervention after an acute MI is more cost-effective in older patients with diabetes mellitus than in those without it.

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Incremental cost-effectiveness ratio (ICER) was calculated from the perspective of reduction in the inhospital incidence of acute heart failure in older patients with acute myocardial infarction after implementing percutaneous coronary intervention.Notes: DM−, nondiabetic; DM+, diabetic. (A) ICER was calculated based on the average total costs; (B) ICER was calculated based on the average treatment costs.Abbreviation: DM, diabetes mellitus.
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f2-cia-9-711: Incremental cost-effectiveness ratio (ICER) was calculated from the perspective of reduction in the inhospital incidence of acute heart failure in older patients with acute myocardial infarction after implementing percutaneous coronary intervention.Notes: DM−, nondiabetic; DM+, diabetic. (A) ICER was calculated based on the average total costs; (B) ICER was calculated based on the average treatment costs.Abbreviation: DM, diabetes mellitus.

Mentions: For older patients with acute MI, the ICER estimate for implementing PCI was higher in diabetics than in nondiabetics when ICER was calculated based on average total costs (−5.30% versus −3.50%) and average treatment costs (−9.60% versus −4.50%) from the perspective of reduction in inpatient incidence of acute HF after implementing PCI (Figure 2).


Impact of type 2 diabetes mellitus on hospitalization costs in older patients with acute myocardial infarction.

Fu KL, Fan GQ, Han L, Wang XZ, Wang J, Wang YS, Zhong M, Zhang Y, Zhang W, Wang ZH - Clin Interv Aging (2014)

Incremental cost-effectiveness ratio (ICER) was calculated from the perspective of reduction in the inhospital incidence of acute heart failure in older patients with acute myocardial infarction after implementing percutaneous coronary intervention.Notes: DM−, nondiabetic; DM+, diabetic. (A) ICER was calculated based on the average total costs; (B) ICER was calculated based on the average treatment costs.Abbreviation: DM, diabetes mellitus.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4008285&req=5

f2-cia-9-711: Incremental cost-effectiveness ratio (ICER) was calculated from the perspective of reduction in the inhospital incidence of acute heart failure in older patients with acute myocardial infarction after implementing percutaneous coronary intervention.Notes: DM−, nondiabetic; DM+, diabetic. (A) ICER was calculated based on the average total costs; (B) ICER was calculated based on the average treatment costs.Abbreviation: DM, diabetes mellitus.
Mentions: For older patients with acute MI, the ICER estimate for implementing PCI was higher in diabetics than in nondiabetics when ICER was calculated based on average total costs (−5.30% versus −3.50%) and average treatment costs (−9.60% versus −4.50%) from the perspective of reduction in inpatient incidence of acute HF after implementing PCI (Figure 2).

Bottom Line: Stenting was an important factor affecting older patients' total hospitalization costs (β=0.685, P=0.000) and treatment costs during the follow-up period (duration of hospital stay only, β=0.508, P=0.000).Stenting was a protective factor for preventing acute HF in the elderly during the follow-up period.From the perspective of reducing the incidence of acute HF in inpatients, implementation of percutaneous coronary intervention after an acute MI is more cost-effective in older patients with diabetes mellitus than in those without it.

View Article: PubMed Central - PubMed

Affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.

ABSTRACT

Background: The purpose of this study was to evaluate the impact of type 2 diabetes mellitus on hospitalization costs in older patients with acute myocardial infarction (MI).

Methods: Retrospective analysis of data from the case retrieval system of Qilu Hospital of Shandong University located in Jinan city of Shandong Province was done for patients with acute MI from January 1, 2011 to December 31, 2012.

Results: Stenting was an important factor affecting older patients' total hospitalization costs (β=0.685, P=0.000) and treatment costs during the follow-up period (duration of hospital stay only, β=0.508, P=0.000). Stenting was also a protective factor in the prevention of acute heart failure (HF) in older patients with acute MI during the follow-up period (odds ratio 0.189, 95% confidence interval 0.059-0.602, P=0.005). Implementation of percutaneous coronary intervention reduced the incidence of acute HF in older inpatients with acute MI (27.8% versus 4.3%, P=0.001) and without diabetes (18.2% versus 3.8%, P=0.001). Moreover, among the elderly, the incremental cost-effectiveness ratio estimate for implementing percutaneous coronary intervention in diabetic patients was higher than in nondiabetic patients.

Conclusion: Stenting was a protective factor for preventing acute HF in the elderly during the follow-up period. From the perspective of reducing the incidence of acute HF in inpatients, implementation of percutaneous coronary intervention after an acute MI is more cost-effective in older patients with diabetes mellitus than in those without it.

Show MeSH
Related in: MedlinePlus