Effect of Hospital Ownership on Outcomes of Heart Failure Hospitalization
| Autor: | Hala Nas, Alexandros Briasoulis, Diane Levine, Alexander C. Egbe, Walid Ibrahim, Jarrett Weinberger, Vwaire Orhurhu, Kartik Kumar, Samson Alliu, Emmanuel Akintoye |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Adolescent 030204 cardiovascular system & hematology Hospitals Private 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Female patient Health care medicine Humans 030212 general & internal medicine Hospital Mortality health care economics and organizations Aged Aged 80 and over Heart Failure Inpatients Inpatient mortality business.industry Mortality rate Ownership Odds ratio Middle Aged medicine.disease Confidence interval United States Hospitalization Male patient Heart failure Emergency medicine Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American journal of cardiology. 120(5) |
| ISSN: | 1879-1913 |
| Popis: | This study aimed to evaluate the impact of hospital ownership on heart failure (HF) hospitalization outcomes in the United States using data from the National Inpatient Sample of the Agency for Healthcare Research and Quality. Hospital ownership was classified into three, namely, nonfederal government, not-for-profit, and for-profit hospitals. Participants were adults hospitalized with a primary diagnosis of HF (2013 to 2014). End points included inpatient mortality, length-of-stay, cost and charge of hospitalization, and disposition at discharge. Of the estimated 1.9 million HF hospitalizations in the United States between 2013 and 2014, 73% were in not-for-profit hospitals, 15% were in for-profit hospitals, and 12% were in nonfederal government hospitals. Overall, mortality rate was 3%, mean length of stay was 5.3 days, median cost of hospitalization was USD 7,248, and median charge was USD 25,229, and among those who survived to hospital discharge, 51% had routine home discharge. There was no significant difference in inpatient mortality between hospital ownership among male patients, but there was a significant difference for female patients. Compared with government hospitals, mortality in female patients was lower in not-for-profit (odds ratio: 0.85 [95% confidence interval: 0.77 to 0.94]) and for-profit hospitals (odds ratio: 0.77 [0.68 to 0.87]). In addition, mean length of stay was highest in not-for-profit hospitals (5.4 days) and lowest in for-profit hospitals (5 days). Although cost of hospitalization was highest in not-for-profit hospitals (USD 7462) and lowest in for-profit hospitals (USD 6,290), total charge billed was highest in for-profit hospitals (USD 35,576) and lowest in government hospitals (USD 19,652). The average charge-to-cost ratio was 3:1 for government hospitals, 3.5:1 for not-for-profit hospitals, and 5.9:1 for for-profit hospitals. In conclusion, there exist significant disparities in HF hospitalization outcomes between hospital ownerships. Outcomes were generally better in for-profit hospitals than other tiers of hospital and, notably, there was a significant difference in inpatient mortality for female patients (but not for male patients). |
| Databáze: | OpenAIRE |
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