Hospital Costs of Acute Pulmonary Embolism

• Published in: The American journal of medicine Vol. 126; no. 2; pp. 127 - 132
• Main Authors: Fanikos, John, RPh, MBA, Rao, Amanda, BS, Seger, Andrew C., PharmD, Carter, Danielle, PharmD, Piazza, Gregory, MD, MS, Goldhaber, Samuel Z., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2013; Elsevier Sequoia S.A
• Subjects: Acute Disease; Aged; Anticoagulants - economics; Anticoagulants - therapeutic use; Chronic obstructive pulmonary disease; Drug Costs - trends; Economics; Economics, Nursing - trends; Female; Health care expenditures; Hospital cost; Hospital Costs; Hospitalization; Humans; Internal Medicine; Length of Stay - economics; Male; Medical treatment; Middle Aged; Pulmonary embolism; Pulmonary Embolism - economics; Pulmonary Embolism - therapy; Venous thromboembolism; Economics; Pulmonary embolism; Hospital cost; Venous thromboembolism
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2012.07.025

Abstract Objective Pulmonary embolism places a heavy economic burden on health care systems, but the components of hospital cost have not been elucidated. We evaluated hospitalized patients with the primary diagnosis of pulmonary embolism. Our goal was to determine the total and component costs associated with their hospital care. Methods We included patients hospitalized at Brigham and Women's Hospital from September 2003 to May 2010. Patient demographics, characteristics, comorbidities, interventions, and treatments were obtained from the electronic medical record. Costs were obtained using the hospital's accounting software and categorized into the areas providing direct patient supplies or care. Results We identified 991 hospitalized patients with acute pulmonary embolism. In-hospital mortality was 4.2%, and 90-day mortality after hospital discharge was 13.8%. The median length of hospital stay was 3 days, and the mean length of hospital stay was 4 days. The mean total hospitalization cost per patient was $8764. Nursing costs, which included room and board, were $5102. Pharmacy ($966) and radiology ($963) costs were similar. Pharmacy costs ($966) were dominated by the use of low-molecular-weight heparin ($232). Radiology costs ($963) were dominated by the use of diagnostic imaging examinations ($672). During the observation period, an average of 160 patients with pulmonary embolism were admitted each year, requiring an annual hospital expense ranging from $884,814 to $1,866,489. Conclusions Pulmonary embolism has a high case fatality rate and remains an expensive illness to diagnose and treat. Nursing costs comprise the largest component of costs.