Background
Methods
Morbidity Category | ICD-9-CM and ICD-10-CA Codes |
---|---|
Hypertension | 401.x, 402.x, 403.x, 404.x, 405.x, I10.x, I11.x, I12.x, I13.x, I15.x |
Secondary Cerebrovascular Disease a
| 362.34, 430.x–438.x, G45.x, G46.x, H34.0, I60.x–I69.x |
Diabetes | 250.0–250.3, 250.4–250.7, 250.8, 250.9, E10.0–E10.9, E11.0–E11.9, E12.0- E12.9, E13.0–E13.9, E14.0-E14.9 |
Cardiac Disorders | 398.91, 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 410.x, 412.x, 425.4–425.9, 428.x, I09.9, I11.0, I13.0, I13.2, I25.5, I21.x, I22.x, I25.2, I42.0, I42.5–I42.9, I43.x, I50.x, P29.0 |
Chronic Pulmonary Disease | 416.8, 416.9, 490.x–505.x, 506.4, 508.1, 508.8, I27.8, I27.9, J40.x–J47.x, J60.x–J67.x, J68.4, J70.1, J70.3 |
Malignancy or Tumour | 140.x–172.x, 174.x–195.8, 196.x–199.x, 200.x–208.x, 238.6, C00.x–C26.x, C30.x–C34.x, C37.x–C41.x, C43.x, C45.x–C58.x, C60.x–C76.x, C77.x–C80.x, C81.x–C85.x, C88.x, C90.x–C97.x |
Dementia | 290.x, 294.1, 331.2, F00.x–F03.x, F05.1, G30.x, G31.1 |
Mood Disorders | 296.x, 311.x, F30.x, F31.x, F32.x, F33.x, F34.x, F38.x, F39.x |
Renal Disease | 403.01, 403.11, 403.91, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 582.x, 583.0–583.7, 585.x, 586.x, 588.0, I12.0, I13.1, N03.2–N03.7, N05.2–N05.7, N18.x, N19.x, N25.0, V42.0, V45.1, V56.x, Z49.0–Z49.2, Z94.0, Z99.2 |
Peripheral Vascular Disease | 093.0, 437.3, 440.x, 441.x, 443.1–443.9, 447.1, 557.1, 557.9, I70.x, I71.x, I73.1, I73.8, I73.9, I77.1, I79.0, I79.2, K55.1, K55.8, K55.9, V43.4, Z95.8, Z95.9 |
Liver Disease | 070.22, 070.23, 070.32, 070.33, 070.44, 070.54, 070.6, 070.9, 456.0–456.2, 570.x, 571.x, 572.2–572.8, 573.3, 573.4, 573.8, 573.9, B18.x, I85.0, I85.9, I86.4, I98.2, K70.0–K70.4, K70.9, K71.1, K72.1, K72.9, K76.5, K76.6, K76.7, K71.3–K71.5, K71.7, K73.x, K74.x, K76.0, K76.2–K76.4, K76.8, K76.9, V42.7, Z94.4 |
Rheumatic Disease | 446.5, 710.0–710.4, 714.0–714.2, 714.8, 725.x, M05.x, M06.x, M31.5, M32.x–M34.x, M35.1, M35.3, M36.0 |
Peptic Ulcer Disease | 531.x–534.x, K25.x–K28.x |
Results
Patient Characteristic | Overall (n = 987) |
---|---|
Sex (% Males) | 55 |
Age (Years) | 72 (20-99) |
Length of Stay in Hospital (Days) | 8 (1-190) |
Died in Hospital (%) | 28*
|
Had Surgery (%) | 18*
|
Accessed Diagnostic Services (%) | |
Diagnostic Investigations | 88 |
Laboratory Services | 97 |
Overall | 99 |
Accessed Acute Care Services (%) | |
Ambulatory Care | 3**
|
Clinical Nutrition | 41*
|
Nursing | 100 |
Pharmacy | 85**
|
Overall | 100 |
Accessed Rehabilitation Services (%) | |
Audiology and Speech Therapy | 38 |
Occupational Therapy | 62**
|
Physiotherapy | 70 |
Recreation Therapy | 2 |
Respiratory Therapy | 42*
|
Social Work | 45 |
Overall | 88 |
Morbidities at Admission (%) | |
Hypertension | 67 |
Secondary Cerebrovascular Disease | 23 |
Diabetes | 15 |
Cardiac Disorders | 10*
|
Chronic Pulmonary Disease | 6*
|
Malignancy or Tumour | 5 |
Dementia | 5 |
Mood Disorders | 3*
|
Renal Disease | 3 |
Peripheral Vascular Disease | 2*
|
Liver Disease | 1 |
Rheumatic Disease | 1 |
Peptic Ulcer Disease | 1*
|
Overall | 81 |
Morbidity, length of stay, and cost
Multimorbidity | RR for In-Hospital Mortality (95% CI) | Days Spent In Hospital | RR for Longer Stay (95% CI) | Dollar Change in Cost Diagnostic Services (95% CI) | Dollar Change in Cost Acute Care Services (95% CI) | Dollar Change in Cost Rehabilitation Services (95% CI) | Dollar Change in Cost Overall (95% CI) |
P-Value for Dollar Change in Cost Overall |
---|---|---|---|---|---|---|---|---|
Hypertension | 0.86 (0.69-1.06) | 9 (4-20) | 1.32*
(1.14-1.53) | $1846.01*
($321.66 to $3817.97) | $6567.21*
($3432.52 to $10,296.64) | $3426.76*
($1621.76 to $6667.09) | $10,324.56*
($5586.55 to $15,862.53) |
p < 0.001 |
Secondary Cerebrovascular Disease | 1.41*
(1.14-1.75) | 9 (4-21) | 1.08 (0.95-1.24) | $2559.95*
($1078.05 to $4401.97) | $4268.28*
($1015.40 to $8195.50) | $1020.98*
($187.84 to $2477.67) | $8675.26*
($3557.60 to $14,724.72) |
p < 0.001 |
Diabetes | 0.86 (0.64-1.17) | 10 (5-26) | 1.18*
(1.02 to 1.36) | $1127.79 (−$662.19 to $3586.67) | $5658.97*
($1220.92 to $11,308.39) | $2826.20*
($1309.58 to $5341.17) | $7581.65*
($7835.58 to $15,357.99) |
p = 0.016 |
Cardiac Disorders | 1.40*
(1.06-1.85) | 12 (4-27) | 1.14 (0.96-1.35) | $3754.75*
($1028.21 to $7613.74) | $4030.50 (−$1004.88 to $10,796.07) | $1004.67 (−$67.81 to $3191.30) | $8259.74*
($531.06 to $18,195.80) |
p = 0.034 |
Chronic Pulmonary Disease | 1.39 (0.99-1.96) | 9 (4-20) | 1.09 (0.87-1.36) | $3005.11*
($1183.36 to $5317.47) | -$2736.45 ($7296.18 to $4283.75) | $2143.12*
($573.89 to $5172.46) | $1069.32 (−$6346.84 to $11,195.36) |
p = 0.804 |
Malignancy or Tumour | 1.32 (0.87-1.99) | 10 (3-43) | 1.08 (0.83-1.40) | -$1267.34 (−$3801.80 to $4622.35) | $3830.40 (−$3029.04 to $14,479.19) | -$97.25 (−$831.66 to $2529.73) | $4521.52 (−$5750.61 to $19,924.11) |
p = 0.443 |
Dementia | 0.97 (0.64-1.49) | 14 (5-26) | 1.19 (0.97-1.46) | $78.64 (−$2260.05 to $4060.67) | $3840.99 (−$2810.53 to $13,882.24) | $1249.18 (−$20.97 to $3929.90) | $5346.22 (−$3998.06 to $18,509.50) |
p = 0.299 |
Mood Disorders | 1.07 (0.59-1.94) | 17 (6-44) | 1.37*
(1.06-1.75) | $3090.06*
($719.04 to $6364.49) | $10,112.11 (−$836.62 to $29,273.87) | $3440.20*
($344.54 to $13,369.57) | $16,818.57*
($1569.25 to $40,450.14) |
p = 0.026 |
Renal Disease | 1.48 (0.96-2.28) | 9 (5-42) | 1.14 (0.84-1.54) | $2610.50 (−$177.15 to $6873.98) | $8763.22 (−$1039.77 to $25,357.48) | $1520.56 (−$353.38 to $8403.06) | $14,969.86*
($69.12 to $38,456.89) |
p = 0.049 |
Peripheral Vascular Disease | 1.16 (0.66-2.06) | 10 (7-15) | 1.24 (0.93-1.64) | $6391.68*
($3331.82 to $10,504.63) | $298.49 (−$5061.45 to $8352.73) | -$544.78 (−$988.97 to $1578.40) | $2218.22 (−$6135.35 to $13,973.98) |
p = 0.646 |
Liver Disease | 1.55 (0.76-3.16) | 11 (8-18) | 1.64*
(1.21-2.23) | $3181.54 (−$128.61 to $8541.41) | $10,737.56 (−$1195.32 to $32,732.61) | $4186.12 (−$319.55 to $37,111.26) | $13,254.18 (−$4186.59 to $44,542.85) |
p = 0.169 |
Rheumatic Disease | 1.76 (0.78-3.95) | 17 (5-45) | 1.24 (0.71-2.18) | -$406.54 (−$4072.03 to $12,134.32) | $9393.44 (−$3464.65 to $35,755.59) | $5273.28*
($1630.79 to $13,757.05) | $10,184.51 (−$9610.37 to $53,007.91) |
p = 0.410 |
Peptic Ulcer Disease | 1.01 (0.32-3.24) | 16 (9-39) | 1.62*
(1.18-2.24) | $9010.32*
($6377.15 to $12,224.36) | $14,473.14 (−$1563.28 to $48,733.45) | $988.84 (−$1033.07 to $58,779.38) | $21,867.99 (−$544.05 to $63,578.35) |
p = 0.058 |
Overall | 1.12 (0.85-1.49) | 9 (4-21) | 1.69*
(1.36-2.10) | $3701.07*
($1500.94 to $6854.65) | $9777.19*
($6156.57 to $14,204.96) | $4949.90*
($2080.47 to $11,239.82) | $16,388.39*
($10,772.65 to $16,388.39) |
p < 0.001 |
Cost and length of stay
Length of Stay | No. of Patients | Median Cost | Mean Cost |
---|---|---|---|
0-1 Day after ICH | 90 | $1909.45 ($1085.58 to $5456.15) | $5457.47 ± $8144.59 ($351.76 to $42,090.59) |
0-30 Days after ICH | 850 | $8397.25 ($4159.22 to $16,829.43) | $12,355.65 ± $12,168.34 ($351.76 to $98,207.53) |
0-365 Days after ICH | 987 | $10,202.73 ($4821.50 to $22,905.50) | $20,165.14 ± $28,433.37 ($351.76 to $256,867.19) |