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Estimated annual healthcare costs after acute pulmonary embolism: results from a prospective multicentre cohort study

Patients surviving acute pulmonary embolism (PE) necessitate long-term treatment and follow-up. We estimated, the chronic economic impact of PE on the German healthcare system.We calculated the direct cost of illness during the first year after discharge for the index PE, analysing data from a multi...

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Main Authors: Mohr, Katharina (Author) , Mildenberger, Philipp (Author) , Neusius, Thomas (Author) , Christodoulou, Konstantinos C (Author) , Farmakis, Ioannis T (Author) , Kaier, Klaus (Author) , Barco, Stefano (Author) , Klok, Frederikus A (Author) , Hobohm, Lukas (Author) , Keller, Karsten (Author) , Becker, Dorothea (Author) , Abele, Christina (Author) , Bruch, Leonhard (Author) , Ewert, Ralf (Author) , Schmidtmann, Irene (Author) , Wild, Philipp (Author) , Rosenkranz, Stephan (Author) , Konstantinides, Stavros (Author) , Binder, Harald (Author) , Valerio, Luca (Author)
Format: Article (Journal)
Language:English
Published: 2024
In: European heart journal - quality of care and clinical outcomes
Year: 2024, Pages: 1-9
ISSN:2058-1742
DOI:10.1093/ehjqcco/qcae050
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1093/ehjqcco/qcae050
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Author Notes:Katharina Mohr, Philipp Mildenberger, Thomas Neusius, Konstantinos C Christodoulou, Ioannis T Farmakis, Klaus Kaier, Stefano Barco, Frederikus A Klok, Lukas Hobohm, Karsten Keller, Dorothea Becker, Christina Abele, Leonhard Bruch, Ralf Ewert, Irene Schmidtmann, Philipp S Wild, Stephan Rosenkranz, Stavros V Konstantinides, Harald Binder, and Luca Valerio, The FOCUS Investigators
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Summary:Patients surviving acute pulmonary embolism (PE) necessitate long-term treatment and follow-up. We estimated, the chronic economic impact of PE on the German healthcare system.We calculated the direct cost of illness during the first year after discharge for the index PE, analysing data from a multicentre prospective cohort study in Germany. Main and accompanying readmission diagnoses were used to calculate DRG-based hospital reimbursements; anticoagulation costs were estimated from the exact treatment duration and each drug's unique national identifier; and outpatient post-PE care costs from guidelines-recommended algorithms and national reimbursement catalogues. Of 1017 patients enrolled at 17 centres, 958 (94%) completed ≥3-month follow-up; of those, 24% were rehospitalized (0.34 [95% CI 0.30-0.39] readmissions per PE survivor). Age, coronary artery, pulmonary and kidney disease, diabetes, and (in the sensitivity analysis of 837 patients with complete 12-month follow-up) cancer, but not recurrent PE, were independent cost predictors by hurdle gamma regression accounting for zero readmissions. The estimated rehospitalization cost was €1138 (95% CI 896-1420) per patient. Anticoagulation duration was 329 (IQR 142-365) days, with estimated average per-patient costs of €1050 (median 972; IQR 458-1197); costs of scheduled ambulatory follow-up visits amounted to €181. Total estimated direct per-patient costs during the first year after PE ranged from €2369 (primary analysis) to €2542 (sensitivity analysis).By estimating per-patient costs and identifying cost drivers of post-PE care, our study may inform decisions concerning implementation and reimbursement of follow-up programmes aiming at improved cardiovascular prevention.
Item Description:Online veröffentlicht ahead of print: 1. Juli 2024, Korrektur und Schriftsatz: 11. Juli 2024
Gesehen am 10.02.2025
Physical Description:Online Resource
ISSN:2058-1742
DOI:10.1093/ehjqcco/qcae050

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