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The current and future financial burden of hospital admissions for heart failure in Canada: a cost analysis
Dat T Tran1, Arto Ohinmaa1, Nguyen X Thanh1
1School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
Insights
Hospital admissions for heart failure in Canada are increasing, with significant costs projected to rise by 2030. Older adults are the primary drivers of these escalating healthcare expenditures.
Area of Science:
- Health Economics
- Cardiology
- Public Health
Background:
- Heart failure represents a significant financial burden and public health challenge.
- Understanding the economic impact of heart failure hospitalizations is crucial for resource allocation.
Purpose of the Study:
- To analyze Canadian heart failure hospitalization costs from 2004-2013.
- To project future heart failure hospitalization costs up to 2030.
Main Methods:
- Utilized the Canadian Institutes for Health Information Discharge Abstract Database.
- Employed multiple linear regression and generalized linear models for trend analysis and cost estimation.
- Conducted a sensitivity analysis including secondary heart failure diagnoses.
Main Results:
- In 2013, heart failure admissions cost $482 million, rising to an estimated $722 million by 2030.
- Older adults (≥80 years) accounted for 52% of projected 2030 costs.
- Including secondary diagnoses, total costs could reach $2.8 billion by 2030.
Conclusions:
- Hospital costs for heart failure in Canada are increasing, mirroring trends in other developed nations.
- Older adults are the largest consumers of hospital services for heart failure.
- Enhanced outpatient care strategies are essential to mitigate rising heart failure admission rates.
Background:
Heart failure is a costly health condition and a major public health concern. We sought to examine the costs of hospital admissions for heart failure between fiscal years 2004 and 2013 in Canada and to model the future costs to 2030.
Methods:
Canadian Institutes for Health Information Discharge Abstract Database was used to identify admissions to hospital with heart failure as the primary diagnosis between fiscal years 2004 and 2013. Multiple linear regression models were used to calculate the trend in prevalence and extrapolate these to 2030. Canadian Institutes for Health Information patient cost estimates were used to identify costs of hospital admissions for heart failure. Generalized linear models were used to estimate average annual costs per heart failure patient. We conducted a sensitivity analysis including all admissions for heart failure in any diagnostic field.
Results:
In 2013, 45 600 (95% confidence interval [CI]: 43 800-47 200) patients were admitted with heart failure as the primary diagnosis, accounting for $482 (95% CI $464-$500) million. By 2030, we estimate 54 000 (95% CI 49 000-60 000) patients and costs of $722 (95% CI $650-$801) million, with older adults (age ≥ 80 yr) accounting for 52% of costs. Including admissions for which heart failure was a secondary diagnosis increases the total cost to $2.8 (95% CI $2.6-$3.0) billion in 2030.
Interpretation:
As in other developed countries, hospital costs related to heart failure in Canada are on the rise. Older adults are the main consumers of such hospital services. Strategies to improve outpatient care to reduce rates of admission for heart failure are needed.
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