title: Impact of type 2 diabetes mellitus on hospitalization costs in older patients with acute myocardial infarction.
abstract: BACKGROUND
  The purpose of this study was to evaluate the impact of type 2 diabetes mellitus on hospitalization costs in older patients with acute myocardial infarction (MI).
  
  
  METHODS
  Retrospective analysis of data from the case retrieval system of Qilu Hospital of Shandong University located in Jinan city of Shandong Province was done for patients with acute MI from January 1, 2011 to December 31, 2012.
  
  
  RESULTS
  Stenting was an important factor affecting older patients' total hospitalization costs (β=0.685, P=0.000) and treatment costs during the follow-up period (duration of hospital stay only, β=0.508, P=0.000). Stenting was also a protective factor in the prevention of acute heart failure (HF) in older patients with acute MI during the follow-up period (odds ratio 0.189, 95% confidence interval 0.059-0.602, P=0.005). Implementation of percutaneous coronary intervention reduced the incidence of acute HF in older inpatients with acute MI (27.8% versus 4.3%, P=0.001) and without diabetes (18.2% versus 3.8%, P=0.001). Moreover, among the elderly, the incremental cost-effectiveness ratio estimate for implementing percutaneous coronary intervention in diabetic patients was higher than in nondiabetic patients.
  
  
  CONCLUSIONS
  Stenting was a protective factor for preventing acute HF in the elderly during the follow-up period. From the perspective of reducing the incidence of acute HF in inpatients, implementation of percutaneous coronary intervention after an acute MI is more cost-effective in older patients with diabetes mellitus than in those without it.
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Kai-li
authors.initials: KL
authors.lastname: Fu
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Guan-qi
authors.initials: GQ
authors.lastname: Fan
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Lu
authors.initials: L
authors.lastname: Han
authors.affiliation: Shandong University of Traditional Chinese Medicine, Ji'nan, People's Republic of China.
authors.forename: Xiao-zhen
authors.initials: XZ
authors.lastname: Wang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Yu-shu
authors.initials: YS
authors.lastname: Wang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhong
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, and Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Geriatric Medicine, Qilu Hospital of Shandong University, Ji'nan, People's Republic of China.
authors.forename: Zhi-hao
authors.initials: ZH
authors.lastname: Wang
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics*; D005260:Female; D006333:Heart Failure / Q000517:prevention & control; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000191:economics* / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000191:economics; D012189:Retrospective Studies; D015607:Stents / Q000191:economics
keywords: aging; diabetes; hospitalization costs; myocardial infarction; vascular