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Hospital Costs for MI Significantly Higher for Patients With PsA
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DESTIN, Fla. — Patients with psoriatic arthritis admitted to the hospital with acute myocardial infarction have significantly higher hospital costs than those without psoriatic arthritis, according to a presenter at the North American Young Rheumatology Investigator Forum.
“Previous studies have shown that psoriatic arthritis itself has also been associated with an increased risk for cardiovascular morbidity and mortality, independent of psoriasis,” Shraddha Jatwani, MD, of Henry Ford Allegiance Health Rheumatology, told attendees at the meeting. “In the studies that we could find looking at health care cost utilizations, we found that patients that had psoriasis and psoriatic arthritis had more inpatient admissions, more outpatient visits and admission fees of about $2,600 in health care costs per inpatient visit. But when we tried to look for data for the costs of hospitalizations admitted specifically for acute myocardial infarction, there was not much data reported.”
To compare the cost of hospitalization between patients admitted with acute myocardial infarction with underlying PsA with those without PsA, Jatwani and colleagues drew information from the National Inpatient Sample database. Focusing on all adult admissions with acute myocardial infarction from 2012 to 2015, the researchers used diagnostic codes to split the patients into two groups based on PsA status. They then evaluated baseline characteristics, total patient costs per admission, length of stay and mortality in each group.
The researchers analyzed data from 2,275,435 admissions with a primary diagnosis of acute myocardial infarction, which included 2,480 patients with underlying PsA. They adjusted for confounding factors, including insurance status, age, sex, race and geographic region, using logistic regression.
According to Jatwani, the mean total hospital costs among patients with acute myocardial infarction were $94,084 for patients with PsA, compared with $78,982 for patients without PsA (P < .05).
Jatwani added that these findings could reflect the greater financial burden involved with the increased cardiovascular risk factors among patients with PsA and recommended that hospitals institute cardiovascular preventive care in patients with PsA at the time of first diagnosis.
“I think the biggest teaching point for us was, regarding cardiovascular preventive care, we have to start talking to patients with psoriatic arthritis, most likely at the time of diagnosis, because we know that there is definitely increased morbidity and mortality associated with it, as well as increased cost,” Jatwani said. “This will help decrease the cost burden. All stakeholders, including us rheumatologists, dermatologists and primary care physicians need to work in integration to start screening these risk factors early on.” – by Jason Laday
Reference:
Jatwani, S. Inpatient cost burden for patients with acute myocardial infarction and underlying psoriatic arthritis: A study of national inpatient sample 2012-2015. Presented at: North American Young Rheumatology Investigator Forum; May 16, 2018; Destin, Florida.
Disclosure: Jatwani reports no relevant financial disclosures.