BACKGROUND:Cardiovascular disease (CVD) is among the costliest conditions in the United States, and cost-effectiveness analyses can be used to assess economic impact and prioritize CVD treatments. We aimed to develop standardized, nationally representative CVD events and selected possible CVD treatment–related complication hospitalization costs for use in cost-effectiveness analyses.METHODS:Nationally representative costs were derived using publicly available inpatient hospital discharge data from the 2012-2018 National Inpatient Sample. Events were identified using the principal International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes. Facility charges were converted to costs using charge-to-cost ratios, and total costs were estimated by applying a published professional fee ratio. All costs are reported in 2021 US dollars. Mean costs were estimated for events overall and stratified by age, sex, and survival status at discharge. Annual costs to the US health care system were estimated by multiplying the mean annual number of events by the mean total cost per discharge.RESULTS:The annual mean number of hospital discharges among CVD events was the highest for heart failure (1 087 000 per year) and cerebrovascular disease (800 600 per year). The mean cost per hospital discharge was the highest for peripheral vascular disease ($33 700 [95% CI, $33 300–$34 000]) and ventricular tachycardia/ventricular fibrillation ($32 500 [95% CI, $32 100–$32 900]). Hospitalizations contributing the most to annual US health care costs were heart failure ($19 500 [95% CI, $19 300–$19 800] million) and acute myocardial infarction ($18 300, [95% CI, $18 200–$18 500] million). Acute kidney injury was the most frequent possible treatment complication (515 000 per year), and bradycardia had the highest mean hospitalization costs ($17 400 [95% CI, $17 200–$17 500]).CONCLUSIONS:The hospitalization cost estimates and statistical code reported in the current study have the potential to increase transparency and comparability of cost-effectiveness analyses for CVD in the United States.

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美国心血管疾病事件和心血管疾病治疗相关并发症住院费用

背景：心血管疾病 (CVD) 是美国最昂贵的疾病之一，成本效益分析可用于评估经济影响并优先考虑 CVD 治疗。我们的目标是制定标准化的、具有全国代表性的 CVD 事件，并选择可能的 CVD 治疗相关并发症住院费用用于成本效益分析。方法：使用来自 2012-2018 年全国住院患者样本的公开住院患者出院数据得出全国代表性费用。使用主要的《国际疾病分类》第九修订版和《国际疾病分类》第十修订版代码来识别事件。使用费用成本比率将设施费用转换为成本，并通过应用公布的专业费用比率来估算总成本。所有费用均以 2021 年美元为单位报告。对总体事件的平均成本进行了估计，并按年龄、性别和出院时的生存状况进行分层。美国医疗保健系统的年度成本是通过将年平均事件数乘以每次出院平均总成本来估算的。 结果：CVD 事件中年平均出院人数最高的是心力衰竭（每年 1 087 000 例） ）和脑血管疾病（每年 800 600 例）。每次出院的平均费用最高的是周围血管疾病（33 700 美元[95% CI，33 300-34 000 美元]）和室性心动过速/心室颤动（32 500 美元[95% CI，32 100 美元-32 900 美元]）。对美国年度医疗保健费用贡献最大的住院治疗是心力衰竭（19 500 美元 [95% CI，19 300–19 800 美元] 百万美元）和急性心肌梗塞（18 300 美元，[95% CI，18 200 美元– 18 500 美元] 百万美元） 。急性肾损伤是最常见的可能治疗并发症（每年 515 000 例），心动过缓的平均住院费用最高（17 400 美元 [95% CI，17 200 美元 - 17 500 美元]）。结论：住院费用估算和统计代码当前研究中报告的结果有可能提高美国 CVD 成本效益分析的透明度和可比性。