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Multicenter Study
. 2014 Nov;7(6):889-95.
doi: 10.1161/CIRCOUTCOMES.114.000925. Epub 2014 Oct 28.

Readmission rates and long-term hospital costs among survivors of an in-hospital cardiac arrest

Paul S Chan  1 , Brahmajee K Nallamothu  2 , Harlan M Krumholz  2 , Lesley H Curtis  2 , Yan Li  2 , Bradley G Hammill  2 , John A Spertus  2 ; American Heart Association’s Get With The Guidelines-Resuscitation Investigators
Affiliations
Multicenter Study

Readmission rates and long-term hospital costs among survivors of an in-hospital cardiac arrest

Paul S Chan et al. Circ Cardiovasc Qual Outcomes. 2014 Nov.

Abstract

Background: Although an in-hospital cardiac arrest is common, little is known about readmission patterns and an inpatient resource use among survivors of an in-hospital cardiac arrest.

Methods and results: Within a large national registry, we examined long-term inpatient use among 6972 adults aged ≥65 years who survived an in-hospital cardiac arrest. We examined 30-day and 1-year readmission rates and inpatient costs, overall and by patient demographics, hospital disposition (discharge destination), and neurological status at discharge. The mean age was 75.8±7.0 years, 56% were men, and 12% were black. There were a total of 2005 readmissions during the first 30 days (cumulative incidence rate, 35 readmissions/100 patients; 95% confidence interval, 33-37) and 8751 readmissions at 1 year (cumulative incidence rate, 185 readmissions/100 patients; 95% confidence interval, 177-190). Overall, mean inpatient costs were $7741±$2323 at 30 days and $18 629±$9411 at 1 year. Thirty-day inpatient costs were higher in patients of younger age (≥85 years, $6052 [reference]; 75-84 years, $7444 [adjusted cost ratio, 1.23; 1.06-1.42; 65-74 years, $8291 [adjusted cost ratio, 1.37; 1.19-1.59; both P<0.001) and black race (whites, $7413; blacks, $9044; adjusted cost ratio, 1.22; 1.05-1.42; P<0.001), as well as those discharged with severe neurological disability or to skilled nursing or rehabilitation facilities. These differences in resource use persisted at 1 year and were largely because of higher readmission rates.

Conclusions: Survivors of an in-hospital cardiac arrest have frequent readmissions and high follow-up inpatient costs. Readmissions and inpatient costs were higher in certain subgroups, including patients of younger age and black race.

Keywords: costs and cost analysis; heart arrest; outcome assessment (health care); patient readmission.

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Conflict of interest statement

Disclosures:

Dr. Chan has served as a consultant for the American Heart Association. Dr. Krumholz discloses that he is the recipient of a research grant from Medtronic, through Yale University, and is chair of a cardiac scientific advisory board for United Health. None of the other authors has any conflicts of interest or financial interests to disclose.

Figures

Figure 1
Figure 1. Study Cohort
Figure 2
Figure 2. Mean Cumulative Incidence for Any Readmission During Follow-up
Cumulative incidence rate represented by solid line and 95% confidence intervals by dashed lines.
See this image and copyright information in PMC

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