Abstract
Comorbidities can have a cumulative effect on hospital outcomes of care, such as the length of stay (LOS), and hospital mortality. This study examines patients hospitalized with congestive heart failure (CHF), a life-threatening condition, which, when it coexists with a burdened disease profile, the risk for negative hospital outcomes increases. Since coexisting conditions co-interact, with a variable effect on outcomes, clinicians should be able to recognize these joint effects. In order to study CHF comorbidities, we used medical claims data from the Centers for Medicare and Medicaid Services (CMS). After extracting the most frequent cluster of CHF comorbidities, we: (i) Calculated, step-by-step, the conditional probabilities for each disease combination inside this cluster; (ii) estimated the cumulative effect of each comorbidity combination on the LOS and hospital mortality; and (iii) constructed (a) Bayesian, scenario-based graphs, and (b) Bayes-networks to visualize results. Results show that, for CHF patients, different comorbidity constructs have a variable effect on the LOS and hospital mortality. Therefore, dynamic comorbidity risk assessment methods should be implemented for informed clinical decision making in an ongoing effort for quality of care improvements.
Highlights
In recent years there is a high surge in the prevalence of chronic diseases with almost half adults having two or more chronic conditions [1]
We examine the effect of comorbidity constructs on the length of stay (LOS) and hospital mortality, among elderly patients admitted to the hospital with a primary diagnosis of congestive heart failure (CHF), in the United
The objective of this work is to study the cumulative effect of comorbidities on the LOS and hospital mortality, for patients who have been diagnosed with CHF
Summary
In recent years there is a high surge in the prevalence of chronic diseases with almost half adults having two or more chronic conditions [1]. When a patient has a condition, chronic or not, in addition to his/her primary diagnosis (Dx ), this disease is known as a comorbidity. Comorbidities can lead to patient complications and may trigger the need for hospitalization, oftentimes with a high risk for increased length of stay (LOS), hospital-acquired conditions, and hospital death [6,7,8]. Their existence is important to be taken into account by physicians, because of their impact on the diagnosis, treatment, prognosis, and outcome [3]
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