Healthcare utilization and costs in ARDS survivors: a 1-year longitudinal national US multicenter study

with the National Institutes of Health, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. Methods: Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey. Adjusted odds ratios for hospitalization and adjusted relative medians for hospital costs were calculated using marginal two-part regression models. Results: Of 859 consenting survivors, 839 (98%) reported healthcare utilization, with 52% female and a mean age of 49 years old. Over 12 months, 339 (40%) patients reported at least one post-discharge hospitalization, with median estimated hospital costs of US$18,756 (interquartile range $7852–46,174; 90th percentile $101,500). Of 16 patient baseline and ICU variables evaluated, only cardiovascular comorbidity and length of stay were associated with hospitalization, and sepsis was associated with hospital costs. At 6-month assessment, better patient-reported physical activity and quality of life status were associated with fewer hospitalizations and lower hospital costs during subsequent follow-up, and worse psychiatric symptoms were associated with increased hospitalizations. Conclusions: This multicenter longitudinal study found that 40% of ARDS survivors reported at least one post-discharge hospitalization during 12-month follow-up. Few patient- or ICU-related variables were associated with hospitalization; however, physical, psychiatric, and quality of life measures at 6-month follow-up were associated with subsequent hospitalization. Interventions to reduce post-ARDS morbidity may be important to improve patient outcomes and reduce healthcare utilization.

Original languageEnglish (US)
Pages (from-to)980-991
Number of pages12
JournalIntensive Care Medicine
Volume43
Issue number7
DOIs
StatePublished - Jul 1 2017

Keywords

  • Cost
  • Critical illness
  • Healthcare
  • Patient readmission
  • Quality of life

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    with the National Institutes of Health, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network (2017). Healthcare utilization and costs in ARDS survivors: a 1-year longitudinal national US multicenter study. Intensive Care Medicine, 43(7), 980-991. https://doi.org/10.1007/s00134-017-4827-8