Cost of hospitalization for aneurysmal subarachnoid hemorrhage in the United States
Cost of hospitalization for aneurysmal subarachnoid hemorrhage in the United States
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DOI：
10.1016/j.clineuro.2019.05.018
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发表时间：
2019-07-01
影响因子：
1.9
通讯作者：
Varelas, Panayiotis
中科院分区：
文献类型：
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作者：
Modi, Sumul;Shah, Kavit;Varelas, Panayiotis
目的：最近有关美国继发于动脉瘤性蛛网膜下腔出血(ASAH)的住院费用趋势的大规模研究尚缺乏。我们试图发现ASAH相关因素对其住院费用的影响。患者和方法：利用国家住院样本选择初步诊断为ASAH的患者。结果：2002-2014年共确诊ASAH患者22831例。经通货膨胀调整后的平均住院费用为82,514美元(标准差+/-54,983美元)。男性的比例较低(31%)，但与女性相比，费用仍然较高，为3385美元(+/-685美元；p<；.001)。住院时间的中位数为16天(四分位数范围为11-23)，住院时间每增加一天，费用增加3228美元(+/-19美元；p<；.001)。接受动脉瘤栓塞术和夹闭术的患者在费用上没有差异。与40岁的患者相比，40-59岁患者的费用增加了3829美元(+/-914美元；p<；.001)，60-79岁的患者增加了4573美元(+/-1033美元；p<；.001)；然而，对于80岁的患者，费用减少了8124美元(+/-1722美元；p<；.001)。几种中枢神经系统并发症也与费用增加有关。结论：ASAH是美国医疗保健系统的重大财政负担。我们能够确定与更高成本相关的许多重要因素，这些结果可能有助于我们了解资源利用情况，并制定未来的成本削减战略。
Objective: Recent large-scale studies describing hospitalization cost trends secondary to aneurysmal sub-arachnoid hemorrhage (aSAH) in the United States are lacking. We sought to discover the impact of aSAH-related factors upon its hospitalization cost.Patients and methods: Patients with a primary diagnosis of aSAH were selected utilizing the National Inpatient Sample. Regression analyses were used to evaluate the impact of aSAH-related factors on hospitalization costs.Results: From 2002-2014, 22,831 cases of aSAH were identified. The inflation-adjusted mean cost of hospitalization was $82,514 (standard deviation +/- $54,983). The proportion of males was lower (31%), but a higher cost of $3385 (+/- $685; p < .001) remained compared to females. Median length of hospitalization was 16 days (interquartile range 11-23) and each day increase in hospitalization was associated with a cost increase of $3228 (+/- $19; p < .001). There was no difference in cost between patients undergoing aneurysmal coiling or clipping. When compared to patients < 40 years old, the increase in cost for patients 40-59 years old was $3829 (+/- $914; p < .001), and $4573 (+/- $1033; p < .001) for patients 60-79 years old; however, for patients >= 80 years old, there was a decrease in cost of $8124 (+/- $1722; p < .001). Several central nervous system complications were also associated with increased cost.Conclusion: aSAH is a significant financial burden on the United States healthcare system. We were able to identify many important factors associated with higher costs, and these results may help us understand resource utilization and develop future cost-reduction strategies.