By: Sara Riascos  Apr. 07, 2022
Background:
Alcohol Dependence is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Acamprosate Calcium is used to help maintain sobriety in alcohol-dependent adults who no longer drink alcohol. Studies have shown that Acamprosate Calcium is an effective medication in the treatment of alcohol dependence.
Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Acamprosate Calcium within 7 days of hospitalization was associated with lower hospital readmission rates for Alcohol Dependence Patients at Adcare Hospital Of Worcester in Wilmington, Delaware, STATE. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis.<> Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.
Methods:
We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at Adcare Hospital Of Worcester between January 2017 to September 2019. Our methodology criteria was as follows:
Results:
Overall, Acamprosate Calcium was associated with lower hospital readmission rates for all Primary ICD/DRG Diagnosis Codes examined at Adcare Hospital Of Worcester. For patients whose primary DRG Diagnosis was “Detoxification Services for Substance Abuse Treatment” (HZ2ZZZZ) and when Acamprosate Calcium was used within 7 days of hospitalization, the readmission rate was 29.81% compared to the cohort where Acamprosate Calcium was not used, whose readmission rate was 32.23%. The readmission odds ratio for these cohorts was 0.89. The use of Acamprosate Calcium was associated with a 11% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD/DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Acamprosate Calcium at Adcare Hospital Of Worcester is shown below.
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Primary ICD/DRG Diagnosis Code | Primary ICD/DRG Diagnosis Code Description | Total Hospitalizations without Acamprosate Calcium | Readmission Without Acamprosate Calcium | Readmission Rate without Acamprosate Calcium | Total Hospitalizations with Acamprosate Calcium | Readmission with Acamprosate Calcium | Readmission Rate with Acamprosate Calcium | Readmission Odds Ratio | Reduction in Readmission with Acamprosate Calcium (%) | Confidence Interval (-) | Confidence Intervals (+) |
---|---|---|---|---|---|---|---|---|---|---|---|
HZ2ZZZZ | Detoxification Services for Substance Abuse Treatment | 7,613 | 2,454 | 32.23% | 104 | 31 | 29.81% | 0.89 | 11% | -3% | -2% |
897 | Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Major Complication Or Comorbidity (MCC) |
Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Alcohol Dependence were not prescribed Acamprosate Calcium within 7 days of discharge.
ICD/DRG CODE | Hospital | Hospitalizations with Alcohol Dependence | % of Hospitalizations without Acamprosate Calcium |
---|---|---|---|
HZ2ZZZZ | Adcare Hospital Of Worcester | 7,644 | 99.59% |
NewYork Presbyterian - Columbia University Medical Center | 4,453 | At Least 99.78% | |
Christus St Michael Hospital | 860 | At least 98.84% | |
897 | Adcare Hospital Of Worcester | 4,117 | 99.37% |
Jefferson Regional Medical Center | 633 | At Least 98.43% | |
NewYork Presbyterian - Columbia University Medical Center | 165 | At Least 93.94% |
Hospitalizations with Alcohol Dependence = Above Listed ICD/DRG Codes
If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11
Conclusions:
According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January January 2017 to September 2019, the use of Acamprosate Calcium within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Alcohol Dependence patients at Adcare Hospital Of Worcester. This analysis shows that a significant number of Patients are not dispensed Acamprosate Calcium after Alcohol Dependence hospitalizations at Adcare Hospital Of Worcester or major US Hospitals.