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Treatment charges and resource use among patients with heart failure enrolled in an MCO

Gregory de Lissovoy1, Marc Zodet, Karen Coyne

  • 1MEDTAP International, Bethesda, Maryland, USA.

Managed Care Interface
|May 25, 2002
PubMed

Insights

Hospital admission for heart failure (HF) significantly increases annual treatment costs by 98%. Expenditures rose substantially post-admission, regardless of patient age, highlighting the economic burden of HF care.

Area of Science:

  • Health Economics
  • Cardiology
  • Healthcare Management

Background:

  • Heart failure (HF) is a significant public health concern with substantial economic implications.
  • Understanding patient-level expenditures associated with HF is crucial for resource allocation and healthcare policy.

Purpose of the Study:

  • To determine patient-level annual expenditures and resource utilization for heart failure (HF).
  • To analyze the change in annual expenditure following a hospital admission for HF.

Main Methods:

  • Retrospective analysis of administrative claims data from 899 adult patients (40-74 years) continuously enrolled in an IPA-model MCO.
  • Data collected for the period 1996-1998, focusing on individuals with a primary HF diagnosis during index hospitalization.
  • Analysis stratified by age groups and pre-index expenditure quintiles.

Main Results:

  • Median annual charges increased by 98% (from $6,026 pre-event to $14,292 post-event) after HF hospitalization.
  • Mean annual charges saw a 105% increase post-event.
  • One-year readmission rates varied from 30% in the lowest expenditure quintile to 63% in the highest.
  • Expenditure and expenditure increase were not significantly related to patient age.

Conclusions:

  • Hospital admission for heart failure is associated with a significant rise in treatment intensity and annual healthcare expenditure.
  • While HF prevalence increases with age, patient-level treatment costs remain comparable across different age groups.
  • Healthcare systems should anticipate and plan for increased resource utilization following HF admissions.

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