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Medical resource use and expenditure in patients with chronic heart failure: a population-based analysis of 88 195
Nuria Farré1,2, Emili Vela3, Montse Clèries3
1Heart Failure Programme, Department of Cardiology, Hospital del Mar, Barcelona, Spain.
Insights
Heart failure (HF) care costs €536.2 million annually in Catalonia, with hospitalizations being the primary expense. Predictors of higher healthcare spending include younger age, comorbidities, and recent hospital admissions.
Area of Science:
- Cardiology
- Health Economics
- Public Health
Background:
- Heart failure (HF) is a significant driver of healthcare expenditure globally.
- Understanding the population-level costs of HF is crucial for resource allocation.
- Previous studies have limited data on the economic burden of HF at a population level.
Purpose of the Study:
- To investigate the distribution and predictors of healthcare expenditure in a large, population-based cohort of heart failure (HF) patients.
- To quantify the total healthcare costs associated with HF care in Catalonia, Spain.
Main Methods:
- A population-based longitudinal study included 88,195 prevalent heart failure (HF) cases in Catalonia, Spain, as of December 31, 2012.
- One-year healthcare resource use and expenditure were analyzed using the CatSalut surveillance system.
- Multivariate analysis identified factors associated with higher healthcare spending.
Main Results:
- Total annual healthcare expenditure for HF patients in 2013 was €536.2 million, representing 7.1% of the total healthcare budget.
- Hospitalization accounted for 39% of total HF expenditure, followed by outpatient care (20%).
- Independent predictors of higher healthcare expenditure included younger age, higher comorbidity burden, and recent HF or all-cause hospitalization.
Conclusions:
- Heart failure care consumes a substantial portion of the healthcare budget in Catalonia, primarily driven by unplanned hospitalizations.
- Identifying key cost drivers and patient predictors can inform resource planning and targeted interventions for HF management.
- This population-level analysis provides valuable insights for health providers to optimize resource distribution in HF patient care.
Aims:
Heart failure (HF) is one of the diseases with greater healthcare expenditure. However, little is known about the cost of HF at a population level. Hence, our aim was to study the population-level distribution and predictors of healthcare expenditure in patients with HF.
Methods And Results:
This was a population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on 31 December 2012 (n = 88 195). We evaluated 1-year healthcare resource use and expenditure using the Health Department (CatSalut) surveillance system that collects detailed information on healthcare usage for the entire population. Mean age was 77.4 (12) years; 55% were women. One-year mortality rate was 14%. All-cause emergency department visits and unplanned hospitalizations were required at least once in 53.4% and 30.8% of patients, respectively. During 2013, a total of €536.2 million were spent in the care of HF patients (7.1% of the total healthcare budget). The main source of expenditure was hospitalization (39% of the total) whereas outpatient care represented 20% of the total expenditure. In the general population, outpatient care and hospitalization were the main expenses. In multivariate analysis, younger age, higher presence of co-morbidities, and a recent HF or all-cause hospitalization were independently associated with higher healthcare expenditure.
Conclusions:
In Catalonia, a large portion of the annual healthcare budget is devoted to HF patients. Unplanned hospitalization represents the main source of healthcare-related expenditure. The knowledge of how expenditure is distributed in a non-selected HF population might allow health providers to plan the distribution of resources in patients with HF.
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