title: Direct medical costs attributable to venous thromboembolism among persons hospitalized for major operation: a population-based longitudinal study.
abstract: BACKGROUND
  We estimated medical costs attributable to venous thromboembolism (VTE) among patients currently or recently hospitalized for major operation.
  
  
  METHODS
  Using Rochester Epidemiology Project resources, we identified all Olmsted County, MN, residents with objectively diagnosed incident VTE within 92 days of hospitalization for major operation during an 18-year period, 1988-2005 (n = 355). One Olmsted County resident hospitalized for major operation without VTE was matched to each case on event date (±1 year), type of operation, duration of previous medical history, and active cancer status. Subjects were followed in Rochester Epidemiology Project provider-linked billing data for standardized, inflation-adjusted direct medical costs from 1 year before index (case's VTE event date and control's matched date) to earliest of death, emigration, or December 31, 2011. We used generalized linear modeling to predict costs for cases and controls and used bootstrapping methods to assess uncertainty and significance of mean adjusted cost differences.
  
  
  RESULTS
  Adjusted mean predicted costs were more than 1.5-fold greater for cases ($55,956) than for controls ($32,718) (P ≤ .001) from index to up to 5 years postindex. Cost differences between cases and controls were greatest within the first 3 months after index (mean difference = $12,381). Costs were greater for cases than controls (mean difference = $10,797) from 3 months to up to 5 years postindex and together accounted for about half of the overall cost difference.
  
  
  CONCLUSIONS
  VTE during or after recent hospitalization for major operation contributes a substantial economic burden; VTE-attributable costs are greatest in the initial 3 months but persist for up to 5 years.
authors: Division of Cardiovascular Diseases and Gonda Vascular Center, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors: Kevin P
authors: KP
authors: Cohoon
authors: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Cynthia L
authors: CL
authors: Leibson
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Jeanine E
authors: JE
authors: Ransom
authors: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors: Aneel A
authors: AA
authors: Ashrani
authors: Division of Trauma, Critical Care and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.
authors: Myung S
authors: MS
authors: Park
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Tanya M
authors: TM
authors: Petterson
authors: K Long Health Economics Consulting LLC, St. Paul, MN.
authors: Kirsten Hall
authors: KH
authors: Long
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Kent R
authors: KR
authors: Bailey
authors: Division of Cardiovascular Diseases and Gonda Vascular Center, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN. Electronic address: heit.john@mayo.edu.
authors: John A
authors: JA
authors: Heit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative; D054556:Venous Thromboembolism / Q000191:economics*
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