Impact of age and procedure on resource use for patients with ischemic heart disease.
OBJECTIVE
Impact of age on healthcare expenditures should be assessed by targeting on specific diseases and controlling for procedures and severity of illness. Relationship between age and resource use in patients receiving acute care medicine for ischemic heart disease (IHD) was examined.


METHODS
We analyzed 19,874 IHD patients treated in 82 academic and 92 community hospitals. Length of stay (LOS), total charges (TC), and high outliers of LOS and TC were analyzed for every age group (under 65 years, 65-74 years, 75 years or older). Independent effects of age on LOS, TC, and high outliers of LOS and TC were determined using multivariate analysis.


RESULTS
7863 (39.6%) patients were under 65 years, 7181 (36.1%) between 65 years and 74 years, and 4830 (24.3%) aged 75 years or older. Proportion of angina or non-medical treatment was significantly different among three age categories (angina 72%, 75%, 71.4%; non-medical 37.3%, 40.9%, 38.9%, respectively). Significant association with LOS or TC was identified in patients receiving coronary artery bypass graft surgery with percutaneous intracoronary intervention, who were most associated with TC high outlier.


CONCLUSIONS
Age had a modest impact on resource use, as compared with procedures. Policy makers need to acknowledge the impact of procedures on healthcare spending.
Kuwabara
Kazuaki
K
Kyushu University, Graduate School of Medical Science, 3-1-1 Maidashi Higashiku, Fukuoka 812-8512, Japan. kazu228@basil.ocn.ne.jp
Imanaka
Yuichi
Y
Matsuda
Shinya
S
Fushimi
Kiyohide
K
Hashimoto
Hideki
H
Ishikawa
Koichi B
KB
Horiguchi
Hiromasa
H
Hayashida
Kenshi
K
Fujimori
Kenji
K
D000046:Academic Medical Centers; D000367:Age Factors; D000368:Aged; D003953:Diagnosis-Related Groups; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006764:Hospitals, Community; D006801:Humans; D007345:Insurance Claim Review; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000628:therapy*; D013222:State Medicine