Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Research and Practice in Thrombosis and Haemostasis

Abstract

Background : From 2017-2018 the Michigan Anticoagulation Quality Improvement Initiative (MAQI2) implemented a multicenter quality improvement project to improve guideline concordant aspirin use among warfarin treated patients with atrial fibrillation and/or venous thromboembolic disease. After 48 months of follow-up, this intervention was associated with reduced bleeding but no increase in thrombosis. The cost savings of this intervention has not been assessed. Aims : To determine insurance payments associated with adverse bleeding and thrombotic events and estimate the potential reduction in payments associated with aspirin deprescribing. Methods : Insurance reimbursement data from the MAQI2 cohort was identified by perfect match of admission/discharge date, birth date, and sex to Michigan Value Collaborative (MVC) claims data from Medicare and private insurance. Total reimbursed facility or professional payments were aggregated, with categories with low events excluded to ensure confidentiality. Emergency department or inpatient claims from Medicare or private insurance were included; other outpatient claims data were not available. We used clinical outcome event rates pre and post intervention to calculate the median and interquartile range (IQR) of dollars reimbursed for each event. Estimated reimbursement savings per 100-patient-years of follow-up was calculated based on pre and post intervention event rates. Results : Major bleeding events were associated with a median cost of $13,661 (IQR $6,601). Non-major bleeding events had a median inpatient cost of $11,678 (IQR $6,050) and median ED cost of $457 (IQR $517). Major bleeding events were reduced by 1.3 bleeds per 100-patient-years post-intervention for a savings of $17,759 per 100-patient-years. Non-major bleeding events were reduced by 8.5 bleeds per 100-patient-years post-intervention, for a savings of $27,108 per 100-patient-years. There were negligible changes in thrombosis costs post intervention. Overall, payment savings were estimated at $44,867 per 100-patientyears of follow-up. Conclusion(s) : Our antithrombotic stewardship intervention was associated with healthcare system payment savings and improved patient outcomes.

Volume

9

Issue

Suppl 2

First Page

42

Last Page

43

Comments

2025 Congress of the International Society of Thrombosis and Haemostasis, June 21-25, 2025, Washington, DC

DOI

10.1016/j.rpth.2025.102925

Download

Share

COinS