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Hospital Costs and Revenue Are Similar for Resuscitated Out-of-hospital Cardiac Arrest and ST-segment Acute Myocardial Infarction Patients

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Abstract:

Abstract Objectives: 

Care provided to patients who survive to hospital admission after out-of-hospital cardiac arrest (OOHCA) is sometimes viewed as expensive and a poor use of hospital resources. The objective was to describe financial parameters of care for patients resuscitated from OOHCA. Methods: 

This was a retrospective review of OOHCA patients admitted to one academic teaching hospital from January 2004 to October 2007. Demographic data, length of stay (LOS), and discharge disposition were obtained for all patients. Financial parameters of patient care including total cost, net revenue, and operating margin were calculated by hospital cost accounting and reported as median and interquartile range (IQR). Groups were dichotomized by survival to discharge for subgroup analysis. To provide a reference group for context, similar financial data were obtained for ST-segment elevation myocardial infarction (STEMI) patients admitted during the same time period, reported with medians and IQRs. Results: 

During the study period, there were 72 admitted OOCHA patients and 404 STEMI patients. OOCHA and STEMI groups were similar for age, sex, and insurance type. Overall, 27 (38.6%) OOHCA patients survived to hospital discharge. Median LOS for OOHCA patients was 4 days (IQR = 1–8 days), with most of those hospitalized for ≤4 days (n = 34, 81.0% dying or discharged to hospice care). Median net revenue ($17,334 [IQR $7,015–$37,516] vs. $16,466 [IQR = $14,304–$23,678], p = 0.64) and operating margin ($7,019 [IQR = $1,875–$15,997] vs. $7,098 [IQR = $3,767–$11,138], p = 0.83) for all OOHCA patients were not different from STEMI patients. Net income for OOCHA patients was not different than for STEMI patients (–$322 vs. $114, p = 0.72). Conclusions: 

Financial parameters for OOHCA patients are similar to those of STEMI patients. Financial issues should not be a negative incentive to providing care for these patients.

ACADEMIC EMERGENCY MEDICINE 2010; 17:612–616 © 2010 by the Society for Academic Emergency Medicine

Keywords: cardiac arrest; cost of care; outcomes; resuscitation

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1553-2712.2010.00747.x

Publication date: June 1, 2010

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