Hypertrophic obstructive cardiomyopathy and the cost of treatment

Abstract

Objective: To evaluate the demographics of patients admitted with Hypertrophic Obstructive Cardio-Myopathy (HOCM) and the financial burden of this disease on the health care system. Methods:The Healthcare Cost and Utilization Project (HCUP), sponsored by The Agency for Healthcare Research and Quality's (AHRQ), includes the largest collection of longitudinal hospital care data in the United States of America. HCUP creates the National In-patient Sample data (NIS) to help conduct national and regional analyses of inpatient care. Using the NIS data (2013), we performed a retrospective cohort study that involved patients who were admitted and treated for HOCM.Results: A total of 2605 patients were admitted for the principal diagnosis of HOCM in 2013.Mean hospitalization was 4.9 days. In our total population, 33% of the patients were above 64 years of age. Mean cost of admission was 25,433$. Private insurance and Medicare or Medicaid paid for 43% and 47% admissions respectively. 76%, 3.5%, 4.6% and 13% patients were discharged to routinely home, another short term hospital, nursing home and for home health care, respectively.Conclusions: HOCM admissions are relatively uncommon but effects all ages. Most of these patients were treated at a private hospital, and the hospital costs were very high. Large number of patients required rehabilitation services after discharge which increase financial burden on health care system.

Clinical and economic burden of obstructive hypertrophic cardiomyopathy in the United States

“…Although several previous studies have examined costs for specific episodes of care, to our knowledge, this is the first study to examine the longitudinal costs of unselected patients with oHCM. In a previous population-based study of patients with oHCM, Jan and colleagues used data from the National Inpatient Sample to assess inpatient costs for 2,605 patients who were hospitalized with a principal diagnosis of oHCM in 2013 [16]. They found a mean length of stay of 4.9 days and mean cost/admission of $25,433-results for length of stay that were similar to those for patients who were hospitalized in our study (5.5 days).…”

“…An important first step in this line of investigation is to understand the clinical and economic burden of oHCM on both patients and the healthcare system. Although there have been several small studies of healthcare resource utilization (HRU) and costs in patients with HCM, these have generally focused on individuals undergoing invasive therapies, and there have been no longitudinal studies among unselected patients [14][15][16]. Moreover, there have been no studies quantifying the clinical and economic burden of patients with obstructive HCM, or the subgroups of patients with asymptomatic or symptomatic oHCM.…”

Quality of life and societal costs in hypertrophic cardiomyopathy: protocol of the AFFECT-HCM study

“…This might be subjective and may sometimes be based on estimations. However, previous cost-of-illness studies used aggregated databases and thus neglected important information about broader costs such as patient and family costs, productivity losses and costs beyond healthcare, which are included in this study [10][11][12]. Secondly, the to-be-used questionnaires are validated for an adult population only, hence minors will be excluded [20].…”

“…1 The structured timeline of the study per subject. QoL quality of life, EQ-5D-5L EuroQol questionnaire, KCCQ Kansas City cardiomyopathy questionnaire, iMCQ medical consumption questionnaire, iPCQ productivity cost questionnaire about broader cost types [10][11][12]. Furthermore, QoL studies are rare and none have measured QoL with the EQ-5D-5L, the required instrument according to Dutch guidelines [5,[13][14][15].…”