Disposition Status and Healthcare Cost Among Older Adults Hospitalized with Acute Systolic Heart Failure

Abstract

Background We examined the disposition status and healthcare cost among older patients ≥75 years of age hospitalized with acute systolic heart failure (AHF). Methods From July 2017 to July 2018, AHF visits were identified by the ICD-10 systolic heart failure code as any primary or secondary diagnosis among adults ≥75 years-old in the Premier Healthcare Database. Results Of 377,063 unique patients with AHF, 135,539 (36%) were ≥75 years-old. Of those, 78,550 (58%) were male, 13,247 (10%) were African American, and 9,048 (6%) were Hispanic. The overall unadjusted in-hospital mortality among adults ≥75 years-old was 5.88%; which did not differ by gender. The median length of stay was 4 days and the median healthcare cost attributed to AHF was $8,456 (IQR: $13,221), which did not differ by gender. While older men were more likely to be discharged to rehabilitation or long-term care facility as compared to older women, this difference did not persist after 83 years of age (Figure). Conclusion With rising cost of care and resource utilization for AHF admissions, understanding reasons behind the differential utilization of rehabilitation and long-term facilities among older patients may be critical to optimize healthcare delivery and reduce readmission rates. We examined the disposition status and healthcare cost among older patients ≥75 years of age hospitalized with acute systolic heart failure (AHF). From July 2017 to July 2018, AHF visits were identified by the ICD-10 systolic heart failure code as any primary or secondary diagnosis among adults ≥75 years-old in the Premier Healthcare Database. Of 377,063 unique patients with AHF, 135,539 (36%) were ≥75 years-old. Of those, 78,550 (58%) were male, 13,247 (10%) were African American, and 9,048 (6%) were Hispanic. The overall unadjusted in-hospital mortality among adults ≥75 years-old was 5.88%; which did not differ by gender. The median length of stay was 4 days and the median healthcare cost attributed to AHF was $8,456 (IQR: $13,221), which did not differ by gender. While older men were more likely to be discharged to rehabilitation or long-term care facility as compared to older women, this difference did not persist after 83 years of age (Figure). With rising cost of care and resource utilization for AHF admissions, understanding reasons behind the differential utilization of rehabilitation and long-term facilities among older patients may be critical to optimize healthcare delivery and reduce readmission rates.