ORLANDO – Considerable regional variation exists across the United States in outcomes, including survival and hospital charges following out-of-hospital cardiac arrest, Dr. Aiham Albaeni reported at the American Heart Association scientific sessions.
He presented an analysis of 155,592 adults who survived at least until hospital admission following non–trauma-related out-of-hospital cardiac arrest (OHCA) during 2002-2012. The data came from the Agency for Healthcare Research and Quality’s Nationwide Inpatient Sample, the largest all-payer U.S. inpatient database.
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Mortality was lowest among patients whose OHCA occurred in the Midwest. Indeed, taking the Northeast region as the reference point in a multivariate analysis, the adjusted mortality risk was 14% lower in the Midwest and 9% lower in the South. There was no difference in survival rates between the West and Northeast in this analysis adjusted for age, gender, race, primary diagnosis, income, Charlson Comorbidity Index, primary payer, and hospital size and teaching status, reported Dr. Albaeni of Johns Hopkins University, Baltimore.
Total hospital charges for patients admitted following OHCA were far and away highest in the West, and this increased expenditure didn’t pay off in terms of a survival advantage. The Consumer Price Index–adjusted mean total hospital charges averaged $85,592 per patient in the West, $66,290 in the Northeast, $55,257 in the Midwest, and $54,878 in the South.
Outliers in terms of cost of care – that is, patients admitted with OHCA whose total hospital charges exceeded $109,000 per admission – were 85% more common in the West than the other three regions, he noted.
Hospital length of stay greater than 8 days occurred most often in the Northeast. These lengthier stays were 10%-12% less common in the other regions.
The explanation for the marked regional differences observed in this study remains unknown.
“These findings call for more efforts to identify a high-quality model of excellence that standardizes health care delivery and improves quality of care in low-performing regions,” said Dr. Albaeni.
He reported having no financial conflicts of interest regarding his study.