Drug Topics - January 2009 - (Page H5) THE COST OF HEPARIN CARE “ We have the technology and the pharmacologic agents that can prevent VTE.” — Alpesh Amin, MD, MBA, professor and interim chair of medicine, and executive director of the University of California Irvine Hospitalist Program patients received prophylaxis meeting ACCP guidelines. Hospitals did best with ischemic stroke patients, providing appropriate prophylaxis to 49 percent. The record was worse for other conditions: 43 percent for myocardial infarction patients, 40 percent for heart failure, 31 percent for lung disease, and 27 percent for cancer. Amin’s current studies paint an even grimmer picture. Among cancer discharges recorded in the Premier Perspective database between January 2002 and December 2006, only 16 percent of 84,000 cancer patients at risk for VTE received appropriate prophylaxis. Cancer patients who did receive appropriate VTE prophylaxis had lower in-hospital mortality rates: 2.6 percent compared to 4.2 percent for patients who received partial prophylaxis. That translates into a 48 percent increase in the risk of in-hospital death for at-risk patients who do not receive appropriate VTE prophylaxis. The total mean hospital cost for partial prophylaxis was $17,128, compared to $15,284 for appropriate prophylaxis. Less drug use costs hospitals more in total-care costs. Results were similar for a larger group of medicalsurgical patients hospitalized for cancer, chronic heart failure, orthopedic surgery, lung disease, and severe infectious disease. Among the 703,000 patients at risk for VTE, 22.3 percent received appropriate prophylaxis. The median length of stay was seven days for patients with appropriate prophylaxis compared to eight days for patients who received only partial prophylaxis. The unadjusted costs were higher for partial prophylaxis ($17,712) than for complete prophylaxis ($15,458). Even after multivariate analysis to adjust for differences between the two treatment groups, total hospital costs were $2,050 lower for patients who received appropriate VTE prophylaxis. “Appropriate prophylaxis for [VTE] makes sense not only from an efficacy or quality-of-care perspective, but also from the economic perspective,” Amin said. He added that these results support clinicians who argue that healthcare systems should look at the total costs of care rather than at individual department budgets. Some hospitals have already abandoned budget silos in favor of system-wide costs and outcomes. “These data help drive care toward outcomes rather than costs,” Amin said. “Making that change comes down to getting the data in front of key decision makers.” Januar y 2009 DRUG TOPICS H5
Table of Contents Feed for the Digital Edition of Drug Topics - January 2009 Drug Topics - January 2009 Contents Letters Up Front Up Front in Depth Community Practice Drug Pipeline: What to Watch in 2009 OTC Community-Aquired MRSA Infections New Products Viewpoint Drug Topics - January 2009 Drug Topics - January 2009 - Drug Topics - January 2009 (Page Cover1) Drug Topics - January 2009 - Drug Topics - January 2009 (Page Cover2) Drug Topics - January 2009 - Drug Topics - January 2009 (Page 1) Drug Topics - January 2009 - Drug Topics - January 2009 (Page 2) Drug Topics - January 2009 - Drug Topics - January 2009 (Page 3) Drug Topics - January 2009 - Contents (Page 4) Drug Topics - January 2009 - Contents (Page 5) Drug Topics - January 2009 - Contents (Page 6) Drug Topics - January 2009 - Contents (Page 7) Drug Topics - January 2009 - Contents (Page 8) Drug Topics - January 2009 - Contents (Page 9) Drug Topics - January 2009 - Contents (Page 10) Drug Topics - January 2009 - Contents (Page H1) Drug Topics - January 2009 - Contents (Page H2) Drug Topics - January 2009 - Contents (Page H1) Drug Topics - January 2009 - Contents (Page H2) Drug Topics - January 2009 - Contents (Page H3) Drug Topics - January 2009 - Contents (Page H4) Drug Topics - January 2009 - Contents (Page H5) Drug Topics - January 2009 - Contents (Page H6) Drug Topics - January 2009 - Contents (Page H7) Drug Topics - January 2009 - Contents (Page H8) Drug Topics - January 2009 - Contents (Page 13) Drug Topics - January 2009 - Up Front (Page 14) Drug Topics - January 2009 - Up Front (Page 15) Drug Topics - January 2009 - Up Front (Page 16) Drug Topics - January 2009 - Up Front (Page 17) Drug Topics - January 2009 - Up Front in Depth (Page 18) Drug Topics - January 2009 - Up Front in Depth (Page 19) Drug Topics - January 2009 - Community Practice (Page 20) Drug Topics - January 2009 - Community Practice (Page 20a) Drug Topics - January 2009 - Community Practice (Page 20b) Drug Topics - January 2009 - Community Practice (Page 21) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 22) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 23) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 24) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 25) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 26) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 27) Drug Topics - January 2009 - OTC (Page 28) Drug Topics - January 2009 - OTC (Page 29) Drug Topics - January 2009 - OTC (Page 30) Drug Topics - January 2009 - OTC (Page 31) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 32) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 33) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 34) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 35) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 36) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 37) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 38) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 39) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 40) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 41) Drug Topics - January 2009 - New Products (Page 42) Drug Topics - January 2009 - New Products (Page 43) Drug Topics - January 2009 - New Products (Page 44) Drug Topics - January 2009 - New Products (Page 45) Drug Topics - January 2009 - New Products (Page 46) Drug Topics - January 2009 - New Products (Page 47) Drug Topics - January 2009 - Viewpoint (Page 48) Drug Topics - January 2009 - Viewpoint (Page Cover3) Drug Topics - January 2009 - Viewpoint (Page Cover4)
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