Hospital Cost Analysis Of Patients With Cardiovascular Events And Revascularisation Procedures In Spain

To estimate hospital costs for cardiovascular (CV) events and revascularisation procedure associated with inpatient care analysing data from 14 acute care Spanish hospitals (RECH network), and to compare these costs with national tariffs for the corresponding diagnosis-related groups (DRGs) for similar events. A retrospective study (period: 2009-2013) collecting data from discharge records (~1,050,000) from adult patients was performed. Mean costs and length of stay per patient were collected for non-fatal events according primary diagnosis (CIE9-MC) including myocardial infarction (MI), unstable angina, congestive heart failure (CHF) with hospitalization, stroke, revascularisation procedures and CV death. Average costs per patient for non-fatal CV events, revascularisation procedures and CV death were estimated according per-patient cost information from the RECH database, that included both AP-DRG and APR-DRG groupers which are used for alternative cost comparisons. Subsequently, observed costs per DRG were compared with national DRG tariffs. All costs were expressed in € for the year 2014. Mean costs based on patient-level data from the RECH network for non-fatal acute MI, unstable angina, CHF with hospitalisation, stroke and revascularisation procedures were €8,669, €3,162, €3,353, €4,644 and €10,159 respectively. Average length of stay for non-fatal events ranged between 5.3 and 10.2 hospitalisation days and between 6.4 and 19.5 for revascularisation procedures. The comparison of costs from the RECH network with national tariffs for AP-DRGs, showed differences of €57 for revascularisation procedures, €298 for CHF with hospitalisation, €1,096 for unstable angina, €1,316 for stroke, €3,794 for CV death and €4,249 for acute MI. Average per-patient costs based on discharge records from the RECH network for CV events and revascularisation procedures were higher than the national tariffs for AP-DRGs of similar events and procedures. These differences may result in important economic consequences for the Spanish health system.