Healthcare Resources Utilization throughout the Last Year of Life after Acute Myocardial Infarction

Ygal Plakht, Harel Gilutz, Jonathan Eli Arbelle, Dan Greenberg, Arthur Shiyovich

Research output: Contribution to journalArticlepeer-review


Healthcare resource utilization (HRU) peaks in the last year-of-life, and accounts for a substantial share of healthcare expenditure. We evaluated changes in HRU and costs throughout the last year-of-life among AMI survivors and investigated whether such changes can predict imminent mortality. This retrospective analysis included patients who survived at least one year following an AMI. Mortality and HRU data during the 10-year follow-up period were collected. Analyses were performed according to follow-up years that were classified into mortality years (one year prior to death) and survival years. Overall, 10,992 patients (44,099 patients-years) were investigated. Throughout the follow-up period, 2,885 (26.3%) patients died. The HRU parameters and total costs were strong independent predictors of mortality during a subsequent year. While a direct association between mortality and hospital services (length of in-hospital stay and emergency department visits) was observed, the association with ambulatory services utilization was reversed. The discriminative ability (c-statistics) of a multivariable model including the HRU parameters for predicting the mortality in the subsequent year, was 0.88. In conclusion, throughout the last year of life, hospital-centered HRU and costs of AMI survivors increase while utilization of ambulatory services decrease. HRUs are strong and independent predictors of an imminent mortality year among these patients.

Original languageEnglish
Article number2773
JournalJournal of Clinical Medicine
Issue number8
StatePublished - 1 Apr 2023


  • acute myocardial infarction
  • costs
  • follow-up
  • healthcare resource utilization
  • prognosis

ASJC Scopus subject areas

  • Medicine (all)


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