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Original Research

EJCM. 2016; 4(2): -


Hypertrophic Obstructive Cardiomyopathy and the cost of treatment

Azam Jan, S Mumtaz Anwar Shah, Somaiya Rehman, Alessio Rungatscher, Naseer Ahmed, Giuseppe Faggian.

Abstract
Objective: To evaluate the demographics of patients admitted with Hypertrophic Obstructive CardioMyopathy(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 . To identify these patients we used ICD-9-CM principal diagnosis code 425.11. Using statistical analysis we compared the demographic characteristics, geographical distribution and the cost of treating these patients. Unweighted, HCUP contains data from more than 7 million hospital stays each year. Weighted, it estimates more than 36 million hospitalizations nationally taken from more than 4,000 HCUP participating hospitals.
Results: A total of 2605 patients were admitted for the principal diagnosis of HOCM in 2013.Mean length of hospital stay was 4.9 days. In our entire population 55% of the patients were women. In our total population,33% of the patients were above 64 years of age, whereas 18% patients were aged below 45. Mean cost of admission was 25,433$ while the mean hospital charge for each patient was 88,646 $.Private insurance paid for 43% admissions while for 47% of patients the payer was either Medicare or Medicaid.82% patients were taken care at private hospitals. 74% patients belonged to a high income area in the country. Teaching hospitals managed 82% of these admissions .Southern region of the country had the highest admission for HOCM. 76% patients were discharged routinely while 3.5% patients were discharged to another short term hospital.4.6% required a nursing home or Rehabilitation Center after discharge and 13% were needing home health care.
Conclusions: HOCM admissions are relatively uncommon but effects all ages. Its admissions were relatively more common in South of USA and in high income population. Most of these patients were treated at a private hospital, and the hospital costs were very high. Large number of patients required health care after discharge which increase financial burden on health care system in addition to already expensive treatment.

Key words: a. The Agency for Healthcare Research and Quality's(AHRQ) b. National Inpatient Sample (NIS) c. Hypertrophic obstructive Cardiomyopathy d. Nursing home and rehabilitation e. Healthcare Cost



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