Association Between the Emergency Heart Failure Mortality Risk Grade (EHMRG30-ST) and Costs of Care
Bibliographic record
Abstract
Background: The Emergency Heart Failure Mortality Risk Grade (EHMRG30-ST) is a clinically validated model that predicts 30-day mortality in heart failure patients presenting to the emergency department (ED). However, the relationship between the EHMRG30-ST score and costs of care remains unclear. In this study, we explored the relationship between the EHMRG30-ST score and costs of care at 90 and 365 days after the index ED visit, and identified predictors of costs at 90 days. Methods: We combined 2 chart review databases, including 11,407 patients presenting to the ED with heart failure between 2004-2007. We estimated the costs from administrative databases. We stratified patients into quintiles (Q) of EHMRG30-ST scores (Q1 = lowest risk; Q5 = highest risk), and compared the total costs in 2021 Canadian dollars at 90 and 365 days by score quintiles. We further examined the cost breakdown by categories. Finally, we used a generalized linear model to identify predictors of 90-day costs. Results: < 0.0001). A positive correlation between EHMRG30-ST risk quintile and cost was observed for subcategories of hospital costs, long-term-care, and home care. Major predictors of 90-day costs were ejection fraction measurement and troponin levels. Conclusions: Higher mortality risk as determined by the EHMRG30-ST score was associated with higher costs for up to 1 year after the initial ED presentation. Our study suggests that costs of care may be another potential dimension of the utility of prognostic risk scores.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".