Trends in syncope testing and admissions in the USA from 2006 through 2019.

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Clinical Autonomic Research Pub Date : 2024-11-19 DOI:10.1007/s10286-024-01089-2
Mohammed Ruzieh, Chen Bai, Stephen E Kimmel, Zachary D Goldberger, Osama Dasa, John W Petersen, Madeline Smoot, Emily S Edwards, Sujay R Kamisetty, Mamoun T Mardini
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Abstract

Introduction: Syncope is common, with bimodal distribution through life, peaking in adolescence and in the elderly, and overall increases in incidence with age among both men and women. In this context, syncope-related visits to emergency departments (ED), hospitalizations, and testing are a significant healthcare cost burden. Ultimately, understanding the volume of testing types and settings of syncope encounters may aid in more effective healthcare utilization and high value care for this patient population.

Methods: Data for this study were collected from the Truven Health Analytics MarketScan Database from 2006 to 2019. This database contains both commercially insured patients and those with Medicare coverage. Patients with the diagnosis of syncope were identified using International Classification of Diseases (ICD)-9 and -10 codes. We assessed the incidence of various tests for syncope evaluation and ED disposition for the study period.

Results: The incidence of syncope among the study cohort rose from nine per 1000 patients to 13 per 1000 patients during the study period. The incidence of testing for syncope among multiple domains (neurologic, cardiac, blood testing) decreased in some categories, but routine testing remained prevalent. Women had a significantly lower incidence of testing in most testing domains. Discharge rate from the ED for patients presenting with syncope remained stable during the study period. However, admission rate to the hospital for those aged > 65 years increased during the study time.

Conclusion: Testing and admissions for syncope remain prevalent and are drivers of healthcare-associated costs. There is a clear need for further work in developing a focused approach in the evaluation of syncope patients in order to mitigate healthcare costs and improve outcomes.

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2006 年至 2019 年美国晕厥检测和入院趋势。
简介晕厥是一种常见病,在人的一生中呈双峰分布,在青春期和老年期达到高峰,男女发病率均随年龄增长而增加。在这种情况下,与晕厥相关的急诊就诊(ED)、住院治疗和检测是一项重大的医疗成本负担。归根结底,了解晕厥的检测类型和就诊环境有助于更有效地利用医疗服务,为这一患者群体提供高价值的医疗服务:本研究的数据收集自 2006 年至 2019 年的 Truven Health Analytics MarketScan 数据库。该数据库包含商业保险患者和医疗保险患者。诊断为晕厥的患者使用国际疾病分类(ICD)-9 和-10 编码进行识别。我们评估了研究期间各种晕厥评估检查和急诊室处置的发生率:结果:在研究期间,研究队列中晕厥的发生率从每 1000 名患者中 9 例上升至 13 例。在多个领域(神经、心脏、血液检测)中,某些类别的晕厥检测发生率有所下降,但常规检测仍然普遍。在大多数检测领域,女性的检测率明显较低。在研究期间,急诊室晕厥患者的出院率保持稳定。然而,在研究期间,年龄大于 65 岁的患者入院率有所上升:结论:晕厥的检测和入院仍很普遍,是医疗相关成本的驱动因素。显然有必要进一步开展工作,在评估晕厥患者时采用有针对性的方法,以降低医疗成本并改善治疗效果。
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来源期刊
Clinical Autonomic Research
Clinical Autonomic Research 医学-临床神经学
CiteScore
7.40
自引率
6.90%
发文量
65
审稿时长
>12 weeks
期刊介绍: Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.
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