Economic burden of cardiovascular events and fractures among patients with end-stage renal disease

Quan V. Doan, Michelle Gleeson, John Kim, Rohit Borker, Robert Griffiths, Robert W. Dubois

Research output: Contribution to journalArticle

Abstract

Objective: To quantify direct medical costs of fractures and cardiovascular diseases among endstage renal disease (ESRD) patients. Methods: Medicare claims data from year 2001 of the United States Renal Data System were used to quantify direct medical costs of acute episodic events (acute myocardial infarction (MI), stroke, heart valve repair, heart valve replacement, fractures) and chronic conditions (arrhythmia, peripheral vascular disease (PVD), heart valve disease (HVD), congestive heart failure (CHF), coronary heart disease, and non-acute stroke). Costs of hospitalized episodes of arrhythmia, PVD, CHF, and angina were also quantified. For acute events, costs were quantified using an episode-of-care approach. For chronic conditions, annualized costs were reported. Only costs specific to the events or conditions of interest were included and reported, in 2006 US dollars. Drug and dialysis-related costs were excluded. Diagnosis and procedure codes were used to identify these events and conditions. Results: Among acute events analyzed as clinical episodes, PVD ($358 million) was associated with the greatest economic burden, followed by CHF, arrhythmia, angina, acute MI, heart valve replacement, hip fracture, acute stroke, heart valve repair, vertebral fracture, and pelvic fracture ($8.6 million). The cost per episode ranged from approximately $12 000 to 104 000. Among chronic conditions, CHF ($681 million) contributed the greatest economic burden; HVD ($100 million) contributed the least. The costs per patient-year ranged from $23 000 to 45 000 among chronic conditions. The costing methodology utilized could contribute to an underestimate of the economic impact of each condition; therefore these results are considered conservative. Conclusion: The economic burden of these selected conditions was substantial to health services payers who finance ESRD patient care. Episodic costs were high for most acute events.

Original languageEnglish (US)
Pages (from-to)1561-1569
Number of pages9
JournalCurrent Medical Research and Opinion
Volume23
Issue number7
DOIs
StatePublished - Jul 2007
Externally publishedYes

Fingerprint

Chronic Kidney Failure
Economics
Costs and Cost Analysis
Heart Valves
Peripheral Vascular Diseases
Heart Failure
Cardiac Arrhythmias
Heart Valve Diseases
Stroke
Kidney
Myocardial Infarction
Episode of Care
Cost of Illness
Hip Fractures
Medicare
Information Systems
Health Services
Coronary Disease
Dialysis
Patient Care

Keywords

  • Arrhythmia
  • Congestive heart failure
  • Cost
  • Dialysis
  • Economic burden
  • End-stage renal disease
  • Fractures
  • Heart valve
  • Ischemic heart disease
  • Myocardial infarction
  • Peripheral vascular disease
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Economic burden of cardiovascular events and fractures among patients with end-stage renal disease. / Doan, Quan V.; Gleeson, Michelle; Kim, John; Borker, Rohit; Griffiths, Robert; Dubois, Robert W.

In: Current Medical Research and Opinion, Vol. 23, No. 7, 07.2007, p. 1561-1569.

Research output: Contribution to journalArticle

Doan, Quan V. ; Gleeson, Michelle ; Kim, John ; Borker, Rohit ; Griffiths, Robert ; Dubois, Robert W. / Economic burden of cardiovascular events and fractures among patients with end-stage renal disease. In: Current Medical Research and Opinion. 2007 ; Vol. 23, No. 7. pp. 1561-1569.
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abstract = "Objective: To quantify direct medical costs of fractures and cardiovascular diseases among endstage renal disease (ESRD) patients. Methods: Medicare claims data from year 2001 of the United States Renal Data System were used to quantify direct medical costs of acute episodic events (acute myocardial infarction (MI), stroke, heart valve repair, heart valve replacement, fractures) and chronic conditions (arrhythmia, peripheral vascular disease (PVD), heart valve disease (HVD), congestive heart failure (CHF), coronary heart disease, and non-acute stroke). Costs of hospitalized episodes of arrhythmia, PVD, CHF, and angina were also quantified. For acute events, costs were quantified using an episode-of-care approach. For chronic conditions, annualized costs were reported. Only costs specific to the events or conditions of interest were included and reported, in 2006 US dollars. Drug and dialysis-related costs were excluded. Diagnosis and procedure codes were used to identify these events and conditions. Results: Among acute events analyzed as clinical episodes, PVD ($358 million) was associated with the greatest economic burden, followed by CHF, arrhythmia, angina, acute MI, heart valve replacement, hip fracture, acute stroke, heart valve repair, vertebral fracture, and pelvic fracture ($8.6 million). The cost per episode ranged from approximately $12 000 to 104 000. Among chronic conditions, CHF ($681 million) contributed the greatest economic burden; HVD ($100 million) contributed the least. The costs per patient-year ranged from $23 000 to 45 000 among chronic conditions. The costing methodology utilized could contribute to an underestimate of the economic impact of each condition; therefore these results are considered conservative. Conclusion: The economic burden of these selected conditions was substantial to health services payers who finance ESRD patient care. Episodic costs were high for most acute events.",
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AU - Doan, Quan V.

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AU - Dubois, Robert W.

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AB - Objective: To quantify direct medical costs of fractures and cardiovascular diseases among endstage renal disease (ESRD) patients. Methods: Medicare claims data from year 2001 of the United States Renal Data System were used to quantify direct medical costs of acute episodic events (acute myocardial infarction (MI), stroke, heart valve repair, heart valve replacement, fractures) and chronic conditions (arrhythmia, peripheral vascular disease (PVD), heart valve disease (HVD), congestive heart failure (CHF), coronary heart disease, and non-acute stroke). Costs of hospitalized episodes of arrhythmia, PVD, CHF, and angina were also quantified. For acute events, costs were quantified using an episode-of-care approach. For chronic conditions, annualized costs were reported. Only costs specific to the events or conditions of interest were included and reported, in 2006 US dollars. Drug and dialysis-related costs were excluded. Diagnosis and procedure codes were used to identify these events and conditions. Results: Among acute events analyzed as clinical episodes, PVD ($358 million) was associated with the greatest economic burden, followed by CHF, arrhythmia, angina, acute MI, heart valve replacement, hip fracture, acute stroke, heart valve repair, vertebral fracture, and pelvic fracture ($8.6 million). The cost per episode ranged from approximately $12 000 to 104 000. Among chronic conditions, CHF ($681 million) contributed the greatest economic burden; HVD ($100 million) contributed the least. The costs per patient-year ranged from $23 000 to 45 000 among chronic conditions. The costing methodology utilized could contribute to an underestimate of the economic impact of each condition; therefore these results are considered conservative. Conclusion: The economic burden of these selected conditions was substantial to health services payers who finance ESRD patient care. Episodic costs were high for most acute events.

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KW - End-stage renal disease

KW - Fractures

KW - Heart valve

KW - Ischemic heart disease

KW - Myocardial infarction

KW - Peripheral vascular disease

KW - Stroke

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