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Relationship Between Heart Failure Hospitalization Costs and Left Ventricular Ejection Fraction in an Advanced Aging

Ryota Kaichi1, Kyohei Marume1,2, Michikazu Nakai3

  • 1Miyazaki Prefectural Nobeoka Hospital Nobeoka Japan.

Circulation Reports
|January 27, 2022
PubMed

Insights

Hospitalization costs for heart failure (HF) patients are linked to left ventricular ejection fraction (LVEF). In older adults, lower LVEF significantly increases HF hospitalization expenses, highlighting LVEF

Area of Science:

  • Cardiology
  • Health Economics
  • Geriatrics

Background:

  • Left ventricular ejection fraction (LVEF) is crucial for heart failure (HF) treatment strategies.
  • Advanced aging societies present unique challenges in managing HF costs.
  • Understanding cost drivers in HF is essential for healthcare resource allocation.

Purpose of the Study:

  • To investigate the association between LVEF and hospitalization costs in HF patients within an aging Japanese population.
  • To determine if LVEF is an independent predictor of hospitalization expenses in different age groups.
  • To analyze cost differences between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) in relation to age.

Main Methods:

  • A consecutive cohort of 346 HF patients admitted to Miyazaki Prefectural Nobeoka Hospital (2015-2018) was analyzed.
  • Patients were categorized into HFrEF (LVEF <40%) and HFpEF (LVEF ≥40%) groups.
  • Statistical analysis compared median hospitalization costs across groups, with a focus on age stratification (≥75 years).

Main Results:

  • Overall, HFrEF patients had higher median hospitalization costs than HFpEF patients, though not statistically significant.
  • In patients aged 75 and older, HFrEF patients incurred significantly higher hospitalization costs than HFpEF patients ($7,240 vs. $6,471; P=0.014).
  • LVEF was identified as an independent negative factor for hospitalization costs in older HF patients (β=-0.0301, P=0.006).
  • Older HFpEF patients had lower costs than younger HFpEF patients, unlike HFrEF patients where age did not significantly impact costs.

Conclusions:

  • The impact of LVEF on hospitalization costs is amplified in older HF patients.
  • LVEF is a significant independent predictor of healthcare costs in elderly individuals with heart failure.
  • Age-related cost patterns differ between HFrEF and HFpEF, suggesting tailored management strategies may be needed.

Keywords:
Ejection fractionHealthcare costsHealthcare economicsHeart failureHospitalization

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