title: Examining the Impact of Rehospitalization on Healthcare Cost of Myocardial Infarction Patients in Beijing: A Retrospective Observational Study.
abstract: To examine the impact of rehospitalization on the healthcare expenditure of myocardial infarction (MI) patients in Beijing.
  
  
  
  Retrospective data of MI patients were retrieved from the Beijing Medical Insurance Database, an administrative database of social medical reimbursement activities for the urban population in Beijing, China. Ten percent of patients diagnosed with MI from January 1 to December 31, 2012 were randomly selected and their first hospitalization was considered as the index event. Their hospital utilization after the index event was extracted till September 30, 2013. Rehospitalization was defined as an event of hospital admission due to the same diagnosis and with a time interval of at least 14 days from the most recent admission. The healthcare cost of patients was analyzed, including inpatient cost and outpatient cost. Patients' demographic characteristics, co-morbidities, and length of hospital stay were also collected from the database.
  
  
  
  Of the 1235 MI patients identified, 335 (mean age of 66.14 ± 15.04 years; 84.18% males) had rehospitalization. The rate of MI recurrence was 27.13%. The annual healthcare expense was significantly higher for MI patients with rehospitalization compared to MI patients without rehospitalization (99,920.43 ± 84,113.52 CNY vs. 58,877.89 ± 93,942.90 CNY; P < 0.001). The significant positive predictors of incurring healthcare expenditure were male gender, age 45 years old or more, length of stay at first hospital admission, whether having rehospitalization (yes/no), co-morbidity (heart failure and diabetes), and admission to a tertiary hospital at first hospital admission.
  
  
  
  There was a high risk of MI recurrence for patients in Beijing. The annual healthcare cost of MI patients with rehospitalization was significantly higher than MI patients without rehospitalization. Male patients of 45 years old or more with heart failure and diabetes are likely to incur higher healthcare expenditure.
authors.affiliation: School of Public Health, Peking University, Beijing, 100191, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Division of Pharmacy Practice and Administration, The University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, 64108, USA. liuyif@umkc.edu.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Health and Family Planning Commission of Yunnan Province, Kunming, 650200, China.
authors.forename: Liankui
authors.initials: L
authors.lastname: Wen
authors.affiliation: Bayer Healthcare Company Ltd., Beijing, 100020, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Wu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing; D002681:China; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000191:economics*; D010359:Patient Readmission / Q000191:economics*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
keywords: Cardiology; Healthcare cost; Myocardial infarction; Rehospitalization