| Appropriate VTE prophylaxis is associated with lower direct medical costs. | |
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MedLine Citation:
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PMID: 21068537 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Alpesh Amin; Mohamed Hussein; David Battleman; Jay Lin; Stephen Stemkowski; Geno J Merli |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Hospital practice (1995) Volume: 38 ISSN: 2154-8331 ISO Abbreviation: Hosp Pract (Minneap) Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-11 Completed Date: 2010-12-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101268948 Medline TA: Hosp Pract (Minneap) Country: United States |
Other Details:
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Languages: eng Pagination: 130-7 Citation Subset: AIM; IM |
Affiliation:
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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 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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