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Keywords:

  • anticoagulants;
  • economics;
  • health services;
  • utilization;
  • heparin;
  • hospitalization;
  • length of stay;
  • outcome assessment (health care);
  • physician's practice patterns;
  • pulmonary embolism;
  • venous thrombosis

Abstract

Objectives:  Hospital administrative data were analyzed to assess treatment patterns, in-hospital mortality, rates of hemorrhagic events and thrombus propagation, utilization of health care resources, and hospital costs associated with various treatments during inpatient care for venous thromboembolism (VTE).

Study Design:  Data from inpatient records were collected for deep venous thrombosis (DVT) and pulmonary embolism (PE) encounters at 132 US hospitals between January 1999 and December 2000. Patients receiving the most frequently employed treatments were compared with respect to demographics, related procedures and diagnostics, length of stay, adverse events, in-hospital mortality, and hospital costs.

Results:  A total of 953 primary DVT and 3933 primary PE admissions were identified. Most admissions involved treatment with unfractionated heparin and vitamin K antagonist (UFH/VKA, 64.2% of admissions), followed by UFH with VKA and low-molecular-weight heparin (UFH/LMWH/VKA, 14.4%), and LMWH/VKA (12.9%). Compared with those treated with UFH/VKA, patients treated with LMWH/VKA experienced higher anticoagulant costs ($540 vs. $106), but lower total hospital costs ($5198 vs. $5977) and shorter lengths of stay (4.4 vs. 5.7 days for those without PE and 5.7 vs. 6.7 days for those with PE).

Conclusions:  UFH/VKA was the most common regimen used to treat VTE. In spite of its higher medication cost, however, treatment with LMWH/VKA was associated with significantly shorter hospital stays and lower total hospitalization costs, compared with UFH/VKA.