284 - Association of Hospital Costs for Pulmonary Hypertension Care with World Health Organization Group Classification

Abstract

Background: Pulmonary hypertension (PH) is classified into 5 World Health Organization (WHO) groups based on clinical, pathological, hemodynamic and treatment characteristics. There is however overlap with some patients having multiple categories. We hypothesized that patients with multiple WHO groups will have higher costs. Methods: We evaluated hospital costs of care based on WHO groups during the one-year period from the initial referral to the University of Virginia PH clinic. Costs between groups were compared with the Kruskall-Wallis test, and multivariable linear regression was used to evaluate the relationship between 1-year costs and WHO group classification adjusted for age. Results: Among 239 patients (age 62.3 ± 13.6 years, 31% female), 199 were classified into a single WHO Group (Group 1: n = 45.7%; Group 2: 24.6%; Group 3: 14.6%; Group 4: 6.5%; Group 5: 8.6%), while 40 were classified into more than one WHO group. In the unadjusted analysis, median costs were higher in patients with multiple WHO classifications versus those with a single WHO classification ($5,469 versus $4,677), but the difference was not statistically significant (P = .57). However, in an age-adjusted linear regression model, there was a significant association between 1-year costs and whether patients were classified into multiple WHO groups or a single WHO group (standardized coefficient 0.15; P = .04). Conclusions: Age-adjusted one-year costs for patients followed in a pulmonary hypertension clinic in a tertiary academic medical center were significantly associated with whether patients had multiple WHO group classifications or a single WHO group classification.