Resource utilization and healthcare costs for acute coronary syndrome patients with and without diabetes mellitus

Abstract

Objective:

This study compared differences in healthcare costs and resource utilization for acute coronary syndrome (ACS) patients with and without diabetes mellitus (DM).

Methods:

A retrospective cohort study of a large, US employer-based claims database identified adults hospitalized for ACS between 01/01/2005 and 12/31/2006 and categorized them based on DM status. Resource utilization and costs during the index hospitalization and in the 12-month follow-up period were compared for ACS patients with and without DM using the propensity score stratification bootstrapping method, adjusting for differences in demographic and clinical characteristics.

Results:

Of 12,502 patients who met selection criteria, 3,040 (24%) had a history of DM and 9,462 (76%) did not. Patients with DM were older, female, and had higher rates of previous cardiovascular and renal diseases. After the propensity score stratification, patients with DM incurred higher index hospitalization costs ($32,577 vs. $29,150, p < 0.01) as well as higher total follow-up healthcare costs ($35,400 vs. $24,080, p < 0.01), including higher inpatient ($17,278 vs. $11,247, p < 0.01), outpatient ($12,357 vs. $8,853, p < 0.01), and pharmacy costs ($5,765 vs. $3,980, p < 0.01).

Limitations:

General limitations exist with any retrospective claims database analysis including potential diagnostic or procedural coding inaccuracies. Additionally, the patient population was representative of a working-age population with employer-sponsored health insurance and results may not be generalizable to other patient populations.

Conclusions:

DM is significantly associated with increased healthcare resource utilization and costs for ACS patients.

Key words::

• Acute coronary syndrome
• Costs
• Diabetes mellitus
• Resource utilization

Transparency

Declaration of funding

This study was funded by Daiichi Sankyo, Inc., and Eli Lilly and Company.

Declaration of financial/other relationships

At the time of this study, all authors were employed by Eli Lilly and Company.

Acknowledgments

The authors wish to acknowledge technical writing support from Dr Susan L. Dennett of Strategic Health Outcomes, Inc. Technical writing support was funded by Eli Lilly and Company.

Notes

*The type of revascularization technique received during the index hospitalization was excluded from the model for sub group analysis for CABG, PCI and no revascularization patients.