Temporal trends in healthcare resource utilization and costs following acute myocardial infarction

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

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Acute myocardial infarction (AMI) is associated with greater utilization of healthcare resources and financial expenditure. Objectives: To evaluate temporal trends in healthcare resource utilization and costs following AMI throughout 2003-2015. Methods: AMI patients who survived the first year following hospitalization in a tertiary medical center (Soroka University Medical Center) throughout 2002-2012 were included and followed until 2015. Length of the in-hospital stay (LOS), emergency department (ED), primary care, outpatient consulting clinic visits and other ambulatory services, and their costs, were evaluated and compared annually over time. Results: Overall 8047 patients qualified for the current study; mean age 65.0 (SD = 13.6) years, 30.3% women. During follow-up, LOS and the number of primary care visits has decreased significantly. However, ED and consultant visits as well as ambulatory-services utilization has increased. Total costs have decreased throughout this period. Multivariate analysis, adjusted for potential confounders, showed as significant trend of decrease in LOS and ambulatory-services utilization, yet an increase in ED visits with no change in total costs. Conclusions: Despite a decline in utilization of most healthcare services throughout the investigated decade, healthcare expenditure has not changed. Further evaluation of the cost-effectiveness of long-term resource allocation following AMI is warranted. Nevertheless, we believe more intense ambulatory follow-up focusing on secondary prevention and early detection, as well as high-quality outpatient chest pain unit are warranted.

Original languageEnglish
Article number6
JournalIsrael Journal of Health Policy Research
Volume9
Issue number1
DOIs
StatePublished - 12 Feb 2020

Keywords

  • Acute myocardial infarction; healthcare resource utilization
  • Costs
  • Temporal trends

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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