Determinants of costs and the length of stay in acute coronary syndromes: a real life analysis of more than 10,000 patients.
OBJECTIVE
The aim of this study was to investigate inpatient costs of acute coronary syndromes (ACS) in Switzerland and to assess the main cost drivers associated with this disease.


RESULTS
We used the national multicenter registry AMIS (acute myocardial infarction in Switzerland) which includes a representative number of 65 hospitals and a total of 11.623 patient records. The following cost modules were analyzed: hospital stay, percutaneous coronary interventions (PCI) and thrombolysis. Expenses were assessed using data from official Swiss national statistical sources. Mean total costs per patient were 12.101 Euro (median 10.929 Euro; 95% CI: 1.161-27.722 Euro). The length of stay ranged from one to 129 days with a mean of 9.5 days (median 8.0 days; 95% CI: 1-23). Overall costs were independently influenced by age, gender and existent co-morbidities, e.g. cerebrovascular disease and diabetes (p < 0.0001).


CONCLUSIONS
Our study determined specific causes for the high costs associated with hospital treatment on a large representative sample. The results should highlight unnecessary expenses and help policy makers to evaluate the base case for a DRG (Diagnosis Related Groups) scenario in Switzerland. Cost weighting of the identified secondary diagnosis should be considered in the calculation and coding of a primary diagnosis for ACS.
Bramkamp
Matthias
M
Department of Internal Medicine, University Hospital of Zurich, RAE B 40, Rämistr. 100, CH-8091 Zurich, Switzerland. Matthias.Bramkamp@usz.ch
Radovanovic
Dragana
D
Erne
Paul
P
Szucs
Thomas D
TD
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000191:economics* / Q000706:statistics & numerical data; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D012042:Registries; D012307:Risk Factors; D013557:Switzerland; D015912:Thrombolytic Therapy / Q000191:economics* / Q000706:statistics & numerical data