Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia.
BACKGROUND
The EPICOR Asia (long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients in Asia) study (NCT01361386) was an observational study of patients hospitalized for acute coronary syndromes (ACS) enrolled in 218 hospitals in eight countries/regions in Asia. This study examined costs, length of stay and the predictors of high costs during an ACS hospitalization.


METHODS AND RESULTS
Data for patients hospitalized for an ACS (n = 12,922) were collected on demographics, medical history, event characteristics, socioeconomic and insurance status at discharge. Patients were followed up at 6 weeks' post-hospitalization for an ACS event to assess associated treatment costs from a health sector perspective. Primary outcome was the incurring of costs in the highest quintile by country and index event diagnosis, and identification of associated predictors. Cost data were available for 10,819 patients. Mean length of stay was 10.1 days. The highest-cost countries were China, Singapore, and South Korea. Significant predictors of high-cost care were age, male sex, income, country, prior disease history, hospitalization in 3 months before index event, no dependency before index event, having an invasive procedure, hospital type and length of stay.


CONCLUSIONS
Substantial variability exists in healthcare costs for hospitalized ACS patients across Asia. Of concern is the observation that the highest costs were reported in China, given the rapidly increasing numbers of procedures in recent years.


TRIAL REGISTRATION
NCT01361386 .
['Jan|Stephen|S|0000-0003-2839-1405', 'Lee|Stephen W-L|SW|', 'Sawhney|Jitendra P S|JPS|', 'Ong|Tiong K|TK|', 'Chin|Chee Tang|CT|', 'Kim|Hyo-Soo|HS|', 'Krittayaphong|Rungroj|R|', 'Nhan|Vo T|VT|', 'Pocock|Stuart J|SJ|', 'Vega|Ana M|AM|', 'Hayashi|Nobuya|N|', 'Huo|Yong|Y|']
D054058:Acute Coronary Syndrome D000368:Aged D001208:Asia D005260:Female D054625:Healthcare Disparities D017721:Hospital Costs D006760:Hospitalization D006801:Humans D007902:Length of Stay D008297:Male D008875:Middle Aged D017064:Process Assessment, Health Care D011446:Prospective Studies D012307:Risk Factors D013997:Time Factors D016896:Treatment Outcome
Hospitalization Acute coronary syndrome Asia Costs Health insurance