title: Economic consequences of ACS-related rehospitalizations in the US.
abstract: OBJECTIVE
  To examine economic consequences related to rehospitalization following initial acute coronary syndrome (ACS) treatment in United States managed care settings.
  
  
  METHODS
  Retrospective observational studies.
  
  
  METHODS
  Retrospective observational studies were conducted on two managed care populations to examine medical encounter insurance claims and charges for ACS-related rehospitalizations following an index hospitalization for new onset ACS (2002-2007). All charges were adjusted to year 2007 United States Dollars (USDs).
  
  
  METHODS
  The main outcomes for this study were the direct charges related to ACS rehospitalizations as captured in two separate medical encounter claims databases.
  
  
  RESULTS
  Of the 11,266 ACS patients identified for analysis in the health system plan, 3588 (32%) had at least one ACS rehospitalization. Of the 97,177 ACS patients enrolled in the nationally representative managed care database, 32,578 (34%) had at least one ACS-related rehospitalization. Multivariate analyses demonstrated that coronary artery bypass graft (CABG) was the strongest predictor of increased charges during the recurrence in both populations (p < 0.0001). When controlling for length of stay (LOS) in the model, CABG remained a significant predictor of increased charges, while percutaneous coronary intervention (PCI) and stent insertion became even stronger predictors of increased charges.
  
  
  CONCLUSIONS
  The costs associated with ACS-related rehospitalizations in a real-world setting are high, even when controlling for known cost drivers such as length of stay.
authors.affiliation: Analytica International, 24 West 40th Street, New York, NY 10018, USA. kberenson@analyticaintl.com
authors.forename: Karina
authors.initials: K
authors.lastname: Berenson
authors.forename: Augustina
authors.initials: A
authors.lastname: Ogbonnaya
authors.forename: Roman
authors.initials: R
authors.lastname: Casciano
authors.forename: Dinara
authors.initials: D
authors.lastname: Makenbaeva
authors.forename: Essy
authors.initials: E
authors.lastname: Mozaffari
authors.forename: Lois
authors.initials: L
authors.lastname: Lamerato
authors.forename: John
authors.initials: J
authors.lastname: Corbelli
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies