PURPOSE: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are major sources of morbidity and mortality. The objective of this study was to quantify the economic burden of DVT/PE and hospital readmission of DVT/PE from a health plan perspective.
METHODS: We conducted a study using the Integrated Health Care Information Services National Managed Care Database, which contains administrative claims information for 25 million patients in 30 managed care organizations from 1998 to 2005. We identified hospital claims containing DVT/PE as a primary or secondary discharge diagnosis. Patients were included if they were enrolled in the health plan for a minimum of 30 days prior to, and 365 days following, the DVT/PE hospitalization. We excluded patients who did not have continuous health plan enrollment or continuous pharmacy benefit during this period. We quantified cost burden by examining the annual DVT/PE-related reimbursements to the plan’s providers. Additionally, we evaluated hospital readmission of DVT/PE.
RESULTS: There were 5,348 and 2,984 patients with the primary discharge diagnosis of DVT and PE, respectively. The average total annual healthcare reimbursement by the plan for DVT and PE were $10,804 and $16,644 respectively, with a significant portion related to the hospitalizations ($9,126 and $14,578 respectively). There were 4,593 and 1,119 patients with a secondary discharge diagnosis of DVT and PE, respectively. The average total annual healthcare reimbursement attributed to DVT and PE for these patients was $7,594 and $13,018, respectively. The hospital readmission rate of DVT/PE was 14% within a year from the initial hospital discharge; up to 45% of the DVT/PE readmissions occurred within the first 30 days. Additionally, DVT and PE hospital readmissions were associated with higher hospitalization reimbursements (($11,862 vs. $9,126 and $14,722 vs. $14,578; respectively).
CONCLUSION: The economic burden of DVT and PE is significant to health plans.
CLINICAL IMPLICATIONS: The financial burden is not only due to the initial hospitalization event, but also due to the high rate of hospital readmission, almost half of which occurred within 30 days.
DISCLOSURE: Alex Spyropoulos, Consultant fee, speaker bureau, advisory committee, etc. Research funding was provided by sanofi-aventis US, Bridgewater, NJ, which manufactures enoxaparin (Lovenox®). Alex Spyropoulos is paid consultant to sanofi-aventis US.