Abstract P338: Differences in Costs, Length of Stay and Mortality for Myocardial Infarction and Related Disorders in Non Federal Hospitals

Abstract

BACKGROUND: Validated estimates of costs, length of stay, and mortality rates are necessary for the treatment and prevention of acute myocardial infarction in patient admitted to federal hospitals. Estimates based on data from few healthcare institutions may not be generalizable to all hospitals. HYPOTHESIS: To assess the hypothesis that there will be significant differences in costs, length of stay, and in-hospital mortality rates between inpatient with: (1) acute myocardial infarction only, (2) diabetic acute myocardial infarction and (3) diabetes only in non federal hospitals. METHODS: Data were extracted and analyzed from 4,400 hospital patients with both diabetes and myocardial infarction using International Classification of Diseases-9-Clinical Modification (ICD 9-CM) primary diagnosis codes from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database. Data were retrospectively extracted from 1,056 hospitals in 42 States. Descriptive and multivariate statistical techniques were used to examine patient characteristics and outcome-related factors associated with the inpatient costs. RESULTS: Patients with acute myocardial infarction only incurred the highest average cost ($68,036, n = 24,791), followed by patients with diabetic myocardial infarction ($65,937, n = 4,400), and diabetes only ($33,680, n = 1,021,933) in 2008 hospital stay. The average LOS was at 6.3 days for myocardial infarction, 7.5 days for diabetic myocardial infarction, 4.95 days for diabetes. Inpatient with myocardial infarction only 2,056 (8.2%), diabetic myocardial infarction 350 (7.9%) and diabetes only 25,377 (2.5%) died during hospitalization. Regression analysis showed that patient comorbidities for both diabetic myocardial infarction were highly significant at p < .0001 ranking from fluid and electrolyte 306 (6.0%), renal failure 558 (12.6%), peripheral vascular disorders 363 (8.2%) and congestive heart failure 306 (6.0%). For each procedure, as days from admission to the first procedure increased, average costs consistently decreased ranging from less than one day ($11, 681.00) to 9 days ($100.00). Also, average costs were significantly high, p < .0001 with patient location, patient disposition, risk mortality and disease severity. Patient gender and ethnicity were also significant, p < .005 and p <.006 respectively. CONCLUSIONS: In conclusion, acute myocardial infarction remains the index for increased inpatient mortality, costs and length of stay in patients with both diabetes and myocardial infarction. Inpatients outcomes could be decreased enormously if patient could be screened and treated appropriately on admission to prevent complications like acute myocardial infarction. This study has revealed that appropriate estimation of costs in acute myocardial infarction disorders would help in accurate allocation of funds for preventive measures.