Document Detail


Hospital resource consumption in patients with diabetes and multivessel coronary disease undergoing revascularization.
MedLine Citation:
PMID:  10977421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify factors responsible for the variation in real hospital costs and length of stay for patients with diabetes undergoing coronary angioplasty or coronary bypass surgery. STUDY DESIGN: Retrospective study of patients with diabetes and coronary artery disease treated at a single hospital. PATIENTS AND METHODS: The study population included 1809 patients with diabetes and multivessel (2-vessel or 3-vessel) coronary artery disease who underwent an initial coronary angioplasty or coronary bypass surgery between 1988 and 1996. After accounting for the extent and severity of the patient's coronary artery disease, a sequential model was used to assess if diabetic characteristics were independently associated with higher hospital resource utilization during revascularization. RESULTS: Multivariate regression results indicated that for patients with diabetes who underwent coronary angioplasty, a baseline creatinine level of > or = 2.0 mg/dL was associated with significantly higher hospital costs and longer length of stay. For patients with diabetes who underwent a coronary bypass surgery only, a baseline creatinine level of > or = 2.5 mg/dL was associated with higher hospital costs and longer hospital length of stay. CONCLUSIONS: After controlling for coronary risk factors, selected diabetes-specific characteristics are associated with higher hospital resource utilization. Risk adjustments in hospital reimbursement may be needed to assure that patients with diabetes who have cardiovascular disease have access to revascularization procedures.
Authors:
S D Culler; W S Weintraub; L J Shaw; E R Becker
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of managed care     Volume:  6     ISSN:  1088-0224     ISO Abbreviation:  Am J Manag Care     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-08-15     Completed Date:  2000-08-15     Revised Date:  2005-07-26    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  217-29     Citation Subset:  H    
Affiliation:
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. sculler@sph.emory.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / economics*
Coronary Artery Bypass / economics*
Coronary Disease / complications,  economics*,  surgery
Diabetes Complications*
Female
Humans
Male
Middle Aged
Prospective Studies
Retrospective Studies
Utilization Review*

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


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