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The economic effect of a tertiary hospital-based heart failure program
Douglas Gregory1, David DeNofrio, Marvin A Konstam
1Cardiovascular Clinical Studies and Tufts University School of Medicine, Boston, Massachusetts, USA. dgregory@ccstrials.com
Journal of the American College of Cardiology
|August 16, 2005
Summary
A tertiary heart failure (HF) program generated substantial revenue, with transplanted patients yielding higher margins. Even without transplantation, high-acuity HF care can be economically beneficial long-term.
Area of Science:
- Health Economics
- Cardiology
- Health Services Research
Background:
- Traditional financial models for clinical programs are often cross-sectional.
- A longitudinal approach using patient utilization data can better estimate the economic impact of specialized programs.
Purpose of the Study:
- To determine the economic effect of a tertiary heart failure (HF) program.
- To estimate the incremental value of an HF program using longitudinal patient utilization data.
Main Methods:
- Utilized a sample of 82 HF patients undergoing cardiac transplant evaluation.
- Employed reliability models to compute cumulative utilization, cost, and reimbursement over time.
- Contrasted the economic contribution of transplanted versus non-transplanted patients.
Main Results:
- Transplanted patients incurred higher hospitalizations and outpatient visits compared to non-transplanted patients.
- Mean first-year contribution margins were $47,847 for transplanted and $10,163 for non-transplanted patients.
- Significant revenue and direct costs were observed for both groups, with higher values for transplanted individuals.
Conclusions:
- Tertiary HF programs at academic centers generate significant demand for inpatient and outpatient services.
- These services yield a positive contribution margin, indicating economic viability.
- Hospitals managing high-acuity HF patients without cardiac transplantation may also achieve favorable long-term economic outcomes.
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