Table 3.
Independent Predictors of Higher 30‐Day Total Cost of Hospitalization in Patients Treated After STEMI
| Predictors | Univariate Regressiona | Multivariate Regressionb | ||
|---|---|---|---|---|
| β (95% CI) | P Value | β (95% CI) | P Value | |
| 30‐day readmission | 0.556 (0.547–0.564) | <0.001 | 0.479 (0.472–0.486) | <0.001 |
| Age group, y | ||||
| <50 | 1 (reference) | 1 (reference) | ||
| 50–64 | 0.078 (0.071–0.085) | <0.001 | 0.019 (0.014–0.025) | <0.001 |
| ≥65 | 0.034 (0.025–0.043) | <0.001 | 0.004 (−0.005 to 0.012) | 0.381 |
| Female sex | −0.092 (−0.099 to −0.085) | <0.001 | −0.056 (−0.061 to −0.052) | <0.001 |
| Anemia | 0.250 (0.236–0.265) | <0.001 | 0.022 (0.014–0.030) | <0.001 |
| Obesity | 0.103 (0.093–0.113) | <0.001 | 0.044 (0.037–0.051) | <0.001 |
| Known coronary artery disease | 0.248 (0.234–0.261) | <0.001 | 0.060 (0.051–0.069) | <0.001 |
| Previous CABG | −0.162 (−0.181 to −0.142) | <0.001 | −0.030 (−0.043 to −0.018) | <0.001 |
| Coagulopathy | 0.604 (0.583–0.625) | <0.001 | 0.123 (0.111–0.136) | <0.001 |
| Diabetes mellitus | 0.088 (0.080–0.095) | <0.001 | 0.017 (0.013–0.022) | <0.001 |
| Peripheral vascular disease | 0.099 (0.084–0.113) | <0.001 | 0.020 (0.011–0.030) | <0.001 |
| Fluid/electrolyte disorders | 0.346 (0.332–0.359) | <0.001 | 0.069 (0.062–0.077) | <0.001 |
| History of CHF | 0.266 (0.254–0.278) | <0.001 | 0.029 (0.021–0.037) | <0.001 |
| Pulmonary hypertension | 0.189 (0.162–0.215) | <0.001 | 0.023 (0.008–0.038) | 0.003 |
| Pulmonary circulation disorders | 1.246 (1.120–1.371) | <0.001 | 0.487 (0.389–0.586) | <0.001 |
| Valvular heart disease | 1.184 (1.073–1.294) | <0.001 | 0.519 (0.448–0.590) | <0.001 |
| Elixhauser comorbidity scores >4 | 0.258 (0.246–0.271) | <0.001 | −0.016 (−0.024 to −0.008) | <0.001 |
| Median household income | ||||
| First quartile | 1 (reference) | 1 (reference) | ||
| Second quartile | 0.053 (0.040–0.066) | <0.001 | 0.053 (0.042–0.064) | <0.001 |
| Third quartile | 0.097 (0.081–0.112) | <0.001 | 0.090 (0.076–0.104) | <0.001 |
| Fourth quartile | 0.165 (0.146–0.185) | <0.001 | 0.157 (0.139–0.176) | <0.001 |
| Primary payer | ||||
| Medicare | 1 (reference) | 1 (reference) | ||
| Medicaid | 0.116 (0.102–0.131) | <0.001 | 0.056 (0.044–0.068) | <0.001 |
| Private including HMO | 0.036 (0.028–0.044) | <0.001 | 0.039 (0.031–0.046) | <0.001 |
| Self‐pay/no charge/other | −0.023 (−0.033 to −0.013) | <0.001 | 0.002 (−0.008 to 0.011) | 0.727 |
| Cardiogenic arrest | 0.630 (0.612–0.647) | <0.001 | 0.178 (0.166–0.191) | <0.001 |
| Cardiogenic shock | 0.761 (0.746–0.776) | <0.001 | 0.157 (0.146–0.168) | <0.001 |
| IABP | 0.829 (0.815–0.843) | <0.001 | 0.171 (0.160–0.182) | <0.001 |
| PVAD | 1.383 (1.320–1.445) | <0.001 | 0.660 (0.611–0.709) | <0.001 |
| Length of hospital stay, d | ||||
| ≤3 | 1 (reference) | 1 (reference) | ||
| 4 to 5 | 0.241 (0.232–0.250) | <0.001 | 0.230 (0.221–0.238) | <0.001 |
| ≥6 | 0.839 (0.830–0.850) | <0.001 | 0.674 (0.663–0.684) | <0.001 |
| Revascularization | ||||
| All PCI | 1 (reference) | 1 (reference) | ||
| CABG only | 0.791 (0.774–0.808) | <0.001 | 0.171 (0.155–0.187) | <0.001 |
| No revascularization | −0.640 (−0.653 to −0.626) | <0.001 | −0.730 (−0.743 to −0.717) | <0.001 |
| Weekend admission | 0.012 (0.005–0.018) | <0.001 | 0.020 (0.015–0.024) | <0.001 |
| Hospital bed size | ||||
| Small | 1 (reference) | 1 (reference) | ||
| Medium | 0.064 (0.010–0.118) | 0.021 | −0.021 (−0.070 to 0.028) | 0.393 |
| Large | 0.119 (0.067–0.172) | <0.001 | −0.021 (−0.068 to 0.027) | 0.393 |
| Hospital location | ||||
| Rural | 1 (reference) | 1 (reference) | ||
| Urban | 0.094 (0.072–0.115) | <0.001 | 0.008 (−0.012 to 0.028) | 0.448 |
| Hospital teaching status | ||||
| Teaching | 0.111 (0.089–0.133) | <0.001 | 0.033 (0.012–0.053) | 0.002 |
| Disposition | ||||
| Home | 1 (reference) | 1 (reference) | ||
| Facilityc | 0.087 (0.066–0.107) | <0.001 | −0.028 (−0.039 to −0.017) | <0.001 |
| AMA/unknown | −0.350 (−0.385 to −0.314) | <0.001 | −0.129 (−0.153 to −0.105) | <0.001 |
AMA indicates against medical advice; CABG, coronary artery bypass graft; CHF, congestive heart failure; CI, confidence interval; HMO, health maintenance organization; IABP, intra‐aortic balloon pump; PCI, percutaneous coronary intervention; PVAD, percutaneous ventricular assist device; STEMI, ST‐segment‐elevation myocardial infarction.
Survey‐specific univariate linear regression model was created with an outcome of log‐transformed cumulative cost for each covariate from Table 1 and the covariates with P<0.1 are listed.
Survey‐specific multivariate linear regression model was created with an outcome of log‐transformed cumulative cost including all predictors with P<0.1 in the univariate analysis.
Facility includes skilled nursing facility, intermediate care facility, and inpatient rehabilitation facility.