Homepage > Research abstracts > Prediction of health-related outcomes and direct medical costs attributable to Acute Myocardial Infarction: an importance of medication adherence
Prediction of health-related outcomes and direct medical costs attributable to Acute Myocardial Infarction: an importance of medication adherence
Researchers: Ygal Plakht1,2, Harel Gilutz1,3,4,5
- Ben-Gurion University of the Negev
- Soroka University Medical Center
- Clalit Research Institute
- Belinson Hospital, Rabin Medical Center
- Tel-Aviv University
Background: We recently developed a new prognostic index (SAMI) with a high ability to predict long-term all-cause mortality for post-AMI patients.
Objectives: To investigate and compare the extent of healthcare resources utilization (HRU) and costs by the SAMI groups and the contribution of drug adherence.
Method: A retrospective study included AMI patients hospitalized at Soroka Medical Center (SUMC), 1.1.2002-31.12.2012.
Data sources: computerized medical records of SUMC, Maccabi and Clalit Health Services.
Baseline data: demographics, AMI hospitalization characteristics and 1-year post-AMI drug adherence.
Follow-up data (up to 10-years post-AMI): HRU (in-hospital and primary medicine) and their total costs.
Data sources: computerized medical records of SUMC, Maccabi and Clalit Health Services.
Baseline data: demographics, AMI hospitalization characteristics and 1-year post-AMI drug adherence.
Follow-up data (up to 10-years post-AMI): HRU (in-hospital and primary medicine) and their total costs.
Findings: Overall 9,548 patients were included, age 66.6±13.9 years, 67.8% men.
Throughout the follow-up (54,128 person-years), the mortality rate was 40.6%.
Compared with the year before the AMI, an increase in the extent HRU was noted during the first post-AMI year, followed by a subsequent declined.
Greater extent of HRU was observed among patients with higher SAMI score (p-for-trend<0.001). The average annual total costs were 12,935, 23,302, 13,400 and 11,500 NIS for the periods of pre-AMI, 1st year, 2nd-5th and 6th-10th years respectively. Full 1-year post-AMI drug adherence was negatively related with in-hospital HRU.
Throughout the follow-up (54,128 person-years), the mortality rate was 40.6%.
Compared with the year before the AMI, an increase in the extent HRU was noted during the first post-AMI year, followed by a subsequent declined.
Greater extent of HRU was observed among patients with higher SAMI score (p-for-trend<0.001). The average annual total costs were 12,935, 23,302, 13,400 and 11,500 NIS for the periods of pre-AMI, 1st year, 2nd-5th and 6th-10th years respectively. Full 1-year post-AMI drug adherence was negatively related with in-hospital HRU.
Conclusions: The extent of HRU is higher in the year following AMI compared with the year before and subsequently declines. HRU is greater among higher risk patients (defined by SAMI) and lower in patients with full drug adherence.
Recommendations: The study results might provide the platform for intervention programs including identification of post-AMI patients with high-risk for HRU, and emphasize an importance of drug adherence in reduction of in-hospital HRU.
Research number: R/20/2015
Research end date: 12/2018