Text

theses

Metabolic syndrome is a clinical condition that is characterized by multiple metabolic and cardiovascular diseases risk factors including obesity, high blood pressure or hypertension, insulin resistance and dyslipidemia. Obesity and hypertension are two of the highly prevalent associated with metabolic syndrome among US population. The obesity prevalence among US adults increased gradually since the 1990s and is now at widespread magnitudes with over two-thirds of US adults either overweight or obese. Alongside the prevalence of hypertension has also amplified, resulting in significant increase of adults who likely meet the criteria for metabolic syndrome and are therefore at the increased risk for more serious chronic condition. Hospital readmission rates for metabolic syndrome did not see decline in the years of modern medicine era.

This paper explores the factors associated with metabolic syndrome patients in terms of length of stay and in hospital cost. The data was obtained through the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) dataset from 2012 to 2014. Study populations with primary diagnosis of metabolic syndrome using ICD-9-CM code were extracted and used for statistical analysis.

Descriptive analysis results showed that compared to non-metabolic syndrome patients, metabolic syndrome patient’s length of stay was longer at mean 5.10 days versus mean 4.57 days for non-metabolic syndrome patients. Additionally, total in-hospital charges for metabolic syndrome patients was 30% higher than non-metabolic syndrome patients. Risk of developing metabolic syndrome in female was slightly elevated than in men. Having metabolic syndrome in White ethnic group was high and exhibited substantial differences among different ethnicity. Lower socioeconomic status patients were 37% more prevalent in having metabolic syndrome than the higher income patients.

Logistic regression and General liner models were used to evaluate cost and length of stay. On average the length of stay was statistically significant longer for hypertension patients p <.0001. In addition, on average total cost was statistically significant higher for hypertension patients p .0004 and for obesity patients p <.0001. Metabolic syndrome patients on average billed $14974.65 more per procedure performed (p <.0001). Number of diagnosis cost $1654.88 more per diagnosis (p <.0001).

The odds ratio analysis concluded that Native American have 22% increase in the odds of having metabolic syndrome than White ethnicity. Male have 1.21 higher odds of having metabolic syndrome than female. It was observed that the odds of 30 years - 60 years of age have 30% higher risk of getting metabolic syndrome as compared to over 60 years of age. In less than or equal to 30 years of age the odds ratio average is 0.52 indicating that the 60 years and above age have high potential risk of getting metabolic syndrome as compared to <= 30 years old. In the ROC curve output of high c-statistics suggests that the model does not predict the outcomes randomly but in a more positive outcome as seen with the c-statistics values of 81.36%, 80.77% and 80.62% for the years 2012-2014 respectively. The result found that Hypertension present patients have 98% higher risk of getting metabolic syndrome as compared to a patient who does not have hypertension present.

ETD_10406

Ph.D.

Includes bibliographical references

doi:10.7282/t3-skfa-pd49

ETD doctoral

The author owns the copyright to this work.