Author + information
- Odunayo Olorunfemi1,
- Gbolahan Ogunbayo2,
- Ayman Elbadawi3,
- Rebecca Ojo4,
- Josephine Adunse4 and
- Amole Ojo5
There is limited national data on the relationship between the cost and the readmissions in the two commonly performed procedures in cardiology and cardiovascular surgery - PCTA and CABG. We sought to review the relationship between the readmission rates and costs for these two procedures.
We extracted the 30 day-readmission data for PCTA and CABG for the 5 year period from 2009 to 2013 in the National Readmissions Database of the Agency for Healthcare Research and Quality (AHRQ) provided by the Healthcare Quality and Utilization Project . We then performed a linear contrast analysis to identify the trends of the readmissions and costs over the study period.
For the 5 years reviewed, there was a total of 522,655 index stays (SD 47,398) on account of PCTA in the sampled population in the dataset. 50.8% of the patients were age 65 yrs and above and 66.7% of them were males. For CABG, there was a total of 199,798 (SD 15,402) index stays of which 57.2% were among those 65 and above while 72.7% of them were males. The total number of 30-day readmissions was 12.4% for PCTA and 14.7% for CABG. The cost per readmission of for PCTA was an average of $12,253.8 (SD 734.7) for PCTA while it was $13,387 (SD 631.5) for CABG. A linear contrast analysis for the trends in readmission over the 5 year period showed that there was no statistically significant downward trend in the percentage of readmissions among those patients 45 years and over for PTCA (F=0.068, p=0.804) as well as for CABG (F=0.200, p=0.674). However, a review of the trends for the cost of readmissions for patients 45 years and over showed a statistically significant trend in annual increase in the cost per readmission for both PCTA (F=35; p=0.002) and for CABG (F=10.250; p=0.024).
The morbidity and cost associated with PTCA and CABG remains high, more so among the older population especially males - both for index admissions and for a readmission within 30 days. The impact of policy changes and standard of care changes over the study period is not yet significantly reflected in terms of reducing readmissions. Costs of the index procedures and re-hospitalization is increasing.