Resource utilization and charges of patients with and without diagnosed venous thromboembolism during primary hospitalization and after elective inpatient surgery: a retrospective study

J Med Econ. 2018 Jun;21(6):595-602. doi: 10.1080/13696998.2018.1445635. Epub 2018 Mar 1.

Abstract

Aims: To assess incremental charges of patients experiencing venous thromboembolisms (VTE) across various types of elective inpatient surgical procedures with administration of general anesthesia in the US.

Methods: The authors performed a retrospective study utilizing data from a nationwide hospital operational records database from July 2014 through June 2015 to compare a group of inpatients experiencing a VTE event post-operatively to a propensity score matched group of inpatients who did not experience a VTE. Patients included in the analysis had a hospital admission for an elective inpatient surgical procedure with the use of general anesthesia. Procedures of the heart, brain, lungs, and obstetrical procedures were excluded, as these procedures often require a scheduled ICU stay post-operatively. Outcomes examined included VTE events during hospitalization, length of stay, unscheduled ICU transfers, number of days spent in the ICU if transferred, 3- and 30-day re-admissions, and total hospital charges incurred.

Results: The study included 17,727 patients undergoing elective inpatient surgical procedures. Of these, 36 patients who experienced a VTE event were matched to 108 patients who did not. VTE events occurred in 0.2% of the study population, with most events occurring for patients undergoing total knee replacement. VTE patients had a mean total hospital charge of $60,814 vs $48,325 for non-VTE patients, resulting in a mean incremental charge of $11,979 (p < .05). Compared to non-VTE patients, VTE patients had longer length of stay (5.9 days vs 3.7 days, p < .001), experienced a higher rate of 3-day re-admissions (3 vs 0 patients) and 30-day re-admissions (7 vs 2 patients).

Conclusions: Patients undergoing elective inpatient surgical procedures with general anesthesia who had a VTE event during their primary hospitalization had a significantly longer length of stay and significantly higher total hospital charges than comparable patients without a VTE event.

Keywords: VTE; Venous thromboembolism; anesthesia; charge; healthcare resource utilization; resource utilization; retrospective; total hospital charge.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia, General
  • Elective Surgical Procedures / statistics & numerical data*
  • Female
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Hospital Charges / statistics & numerical data
  • Hospitalization / economics*
  • Humans
  • Inpatients / statistics & numerical data*
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Models, Econometric
  • Patient Readmission / economics
  • Propensity Score
  • Retrospective Studies
  • Socioeconomic Factors
  • Venous Thromboembolism / diagnosis*
  • Venous Thromboembolism / economics*
  • Young Adult