主题：Hospitalizations

May 3, 2011 -- People with atrial fibrillation, a common type of abnormal heart rhythm, are hospitalized twice as often as people without the condition, and costs of treatment are high, a new study suggests.

Not only are people with atrial fibrillation hospitalized more often, they have three times the rate of multiple hospitalizations compared to people without the disorder, and four times as many cardiovascular admissions, according to the study.

Treating people with atrial fibrillation added $26 billion to the nation’s health care bill in just one year, including $6 billion for atrial fibrillation care and $10.1 billion for non-cardiovascular health problems.

Atrial Fibrillation Hospitalizations, Cost on the Rise

“Atrial fibrillation places a huge economic burden on health care payers, patients, and our country,” says Michael H. Kim, MD, of Northwestern University and author of the study. “It is not clear that the country realizes that atrial fibrillation patients are much more likely to have cardiovascular hospitalizations specifically, and more hospitalizations in general.”

Atrial fibrillation is an irregular heart rhythm that occurs when the heart’s upper chambers beat erratically, causing chambers to pump blood inefficiently. It can cause blood to pool and clot in the chambers, increasing the risk of stroke and heart attack.

The condition affects about 3 million American adults, and that number is expected to double over the next 25 years, adding to the cost burden.

Study Methodology

Researchers examined data on 89,066 people with atrial fibrillation from two medical records databases that totaled 38 million people. The scientists matched patients with atrial fibrillation with a comparison group without the condition, and followed each pair for 12 months during 2004-2006.

Among key findings:

• 2.1% of patients with atrial fibrillation died in the hospital, compared to 0.1% without the condition.
• 75% of patients with atrial fibrillation were covered by Medicare.
• Atrial fibrillation patients entered the hospital, for any reason, twice as often as patients without the disorder and were three times as likely to have multiple hospitalizations.
• Atrial fibrillation patients were hospitalized for cardiovascular problems four times more than people without the problem, and had multiple cardiovascular hospital admissions eight times more often.
• Total direct health care costs averaged $20,670 for the atrial fibrillation group and $11,965 for those without the disorder. The difference of $8,705 was due mostly to inpatient services.
• Among patients studied, 19.5% of atrial fibrillation patients were newly diagnosed.

?“We’re not going to impact health care costs or cardiovascular outcomes by just addressing atrial fibrillation itself,” Kim says in a news release. “The large amount of cardiovascular disease among atrial fibrillation patients appears to worsen outcomes and increase costs. This is a sicker population.”

March 27, 2008 -- The CDC reports a dramatic rise in the number of U.S. hospitalizations of kidney disease.

The annual number of those hospitalizations quadrupled from 1980 to 2005, according to the CDC.

That figure rose from about 416,000 hospitalizations in 1980 to 1.6 million in 2005, for a total of about 10 million hospitalizations from 1980 to 2005.

Those numbers are hospitalizations, not patients. Some kidney disease patients may have been hospitalized more than once.

Also, kidney disease wasn't always the reason for hospitalization. Some people were hospitalized for other reasons, including heart attack or heart failure. If their hospital discharge record noted kidney disease, that counted as a kidney disease hospitalization.

The rise in kidney disease hospitalizations was greatest in people aged 65 and older. Acute renal failure cases were up sharply, driving the trend. Acute renal failure refers to?sudden and usually temporary loss of kidney function.

In 2005, acute renal failure accounted for 60% of kidney disease hospitalizations, up from 7% in 1980. Kidney disease hospitalization rates were consistently 30% to 40% higher among men than among women from 1980 to 2005, according to the CDC.

Why the increase in kidney disease hospitalizations? The CDC has two theories:

• The aging population. Type 2 diabetes and high blood pressure, which make kidney disease more likely, become more common with age. So an older population makes for more patients.
• Changes in the way acute renal failure is diagnosed, defined, or coded in hospital records. The National Kidney Foundation issued new guidelines on chronic kidney disease in 2002.

The kidney disease hospitalization statistics, based on discharge records from about 500 U.S. hospitals, appear in tomorrow's edition of the CDC's Morbidity and Mortality Weekly Report.

Aug. 9, 2007 -- When heat waves hit, more senior citizens are hospitalized, a new Italian study shows.

The researchers included Giuseppe Mastrangelo, MD, of Italy's University of Padova.

They tracked hospitalizations among people age 75 and older during five heat waves that took place in Italy's Veneto region during 2002 and 2003.

Mastrangelo's team noted a rise in hospitalizations for heat-related conditions (dehydration, heat stroke, and acute kidney failure) among elders.

"At least four consecutive hot, humid days were required to observe a major increase in hospital admissions," write Mastrangelo and colleagues.

For instance, elders' hospitalizations for heat-related conditions more than doubled and their hospitalizations for respiratory diseases rose by about 50% when heat waves lasted for at least four days.

Heat waves that struck later in the summer didn't appear to lead to fewer hospitalizations than heat waves that hit earlier in the season.

That finding suggests that people don't get used to the heat as the summer progresses, the researchers note online in the journal BMC Public Health.

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Heat Wave Health

More than 8,000 people in the U.S. died from excessive heat exposure between 1979 and 2003, according to the CDC.

Heat-related deaths and illnesses are often preventable. Here are the CDC's tips:

• Stay indoors in an air-conditioned place.
• Drink plenty of fluids -- and not just when you're thirsty -- unless your doctor advises otherwise or you're taking water pills (diuretics).
• A sports drink can replace salt and minerals lost in sweat. Talk to your doctor first if you're on a low-salt diet.
• Wear as little clothing as possible at home.
• Choose lightweight, light-colored, loose-fitting clothes.
• Limit your outdoor activity. If you must go out, aim for the morning or evening.
• When outside, try to rest often in shady areas.
• Wear a wide-brimmed hat, sunglasses, and sunscreen with an SPF of 15 or higher.
• Pace yourself, and stop all activity if your heart pounds or you start gasping for breath in the heat.
• Check on babies, kids, elders, people who are ill, and others who may be particularly vulnerable to heat-related illnesses.