Document Detail


Appropriate VTE prophylaxis is associated with lower direct medical costs.
MedLine Citation:
PMID:  21068537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To calculate and compare the direct medical costs of guideline-recommended prophylaxis with prophylaxis that does not fully adhere with guideline recommendations in a large, real-world population.
METHODS: Discharge records were retrieved from the US Premier Perspective™ database (January 2003-December 2003) for patients aged≥40 years with a primary diagnosis of cancer, chronic heart failure, lung disease, or severe infectious disease who received some form of thromboprophylaxis. Univariate analysis and multivariate regression modeling were performed to compare direct medical costs between discharges who received appropriate prophylaxis (correct type, dose, and duration based on sixth edition American College of Chest Physicians [ACCP] recommendations) and partial prophylaxis (not in full accordance with ACCP recommendations). Market segmentation analysis was used to compare costs stratified by hospital and patient characteristics.
RESULTS: Of the 683 005 discharges included, 148,171 (21.7%) received appropriate prophylaxis and 534,834 (78.3%) received partial prophylaxis. The total direct unadjusted costs were $15,439 in the appropriate prophylaxis group and $17,763 in the partial prophylaxis group. After adjustment, mean adjusted total costs per discharge were lower for those receiving appropriate prophylaxis ($11,713; 95% confidence interval [CI], $11,675-$11,753) compared with partial prophylaxis ($13,369; 95% CI, $13,332-$13 406; P<0.01). Appropriate prophylaxis appeared to be associated with numerically lower unadjusted costs than partial prophylaxis, regardless of hospital size, rural/urban location, teaching status, and patient age and gender.
CONCLUSION: This large, real-world analysis suggests that appropriate prophylaxis, in adherence with ACCP guidelines, is potentially cost-saving compared with partial prophylaxis in at-risk medical patients.
Authors:
Alpesh Amin; Mohamed Hussein; David Battleman; Jay Lin; Stephen Stemkowski; Geno J Merli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hospital practice (1995)     Volume:  38     ISSN:  2154-8331     ISO Abbreviation:  Hosp Pract (Minneap)     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101268948     Medline TA:  Hosp Pract (Minneap)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-7     Citation Subset:  AIM; IM    
Affiliation:
School of Medicine, University of California-Irvine, 101 The City Drive South, Building 58, Room 110, ZC-4076H, Orange, CA 92868, USA. anamin@uci.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anticoagulants* / economics,  therapeutic use
Cost of Illness
Cost-Benefit Analysis
Direct Service Costs / statistics & numerical data*
Drug Costs
Female
Guideline Adherence / organization & administration
Health Services Research
Hospital Costs / statistics & numerical data*
Humans
Linear Models
Male
Marketing of Health Services
Middle Aged
Multivariate Analysis
Patient Discharge / economics*
Physician's Practice Patterns / organization & administration*
Practice Guidelines as Topic
Retrospective Studies
United States / epidemiology
Venous Thromboembolism / economics,  epidemiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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