Healthcare costs utilization and costs of patients hospitalized with acute respiratory distress syndrome (ARDS) in US commercially-insured individuals and Medicare beneficiaries

Abstract

Introduction: Managing ARDS is resource-intensive, but published quantitative data are limited.

Objective: To examine the healthcare resource utilization (HRU) and costs of patients hospitalized with ARDS.

Methods: US administrative claims between 2009 and 2013 of commercially-insured individuals and Medicare beneficiaries were analyzed. Patients with ARDS who received mechanical ventilation during the index hospitalization were selected. Each ARDS patient was demographically matched to 10 non-ARDS hospitalized controls. HRU, costs, and comorbidities during one-year prior (baseline), were compared, as were characteristics of the index hospitalization. One-year HRU and costs of a subgroup who were discharged alive and had at least one year follow-up were also examined.

Results: Commercially-insured hospitalized ARDS patients had greater comorbid conditions and prior hospitalizations than matched controls. During the index hospitalization, ARDS patients had longer stays (16.7 vs. 4.6 days), higher mortality (11.9% vs. 0.8%), and incurred higher costs than controls ($117,137 vs. $25,199; all p<0.05). ARDS patients who survived to discharge were more likely to be re-hospitalized (53.2% vs. 12.9%) and incurred higher annual total costs ($82,749 vs. $22,670; both p<0.05) during the subsequent year. Trends were similar for Medicare beneficiaries.

Conclusion: Patients hospitalized with ARDS incurred significantly higher resource utilization and costs than non-ARDS hospitalizations during and prior to the stay. The pattern persists for one year after hospital discharge.