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Published on: June 12, 2021
Healthcare consumption of patients with left ventricular assist device: real-world data
Lena Bosch1, Peter-Paul M Zwetsloot1, Maaike Brons1
1Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Insights
Healthcare utilization for patients with left ventricular assist devices (LVADs) increased significantly over six years. This growing LVAD population requires specialized medical care and resource allocation.
Area of Science:
- Cardiology
- Medical Device Technology
- Health Services Research
Background:
- Left ventricular assist devices (LVADs) are critical for end-stage heart failure.
- LVAD therapy is intensive and requires significant healthcare resources.
- Evaluating healthcare consumption in LVAD patients is crucial for resource planning.
Purpose of the Study:
- To assess healthcare consumption patterns in a cohort of LVAD patients over a 6-year period.
- To analyze trends in hospital stays, outpatient visits, and emergency department visits.
- To understand the evolving healthcare needs of an increasing LVAD population.
Main Methods:
- Retrospective analysis of LVAD patients implanted between 2016-2021.
- Data collection included subsequent hospitalizations, outpatient clinic visits, and emergency department visits.
- Analysis focused on total and per-patient-year healthcare utilization.
Main Results:
- 226 LVADs implanted from 2016-2021, with increasing annual implantations.
- Median hospital stay around implantation was 41 days.
- Significant increases in total annual outpatient visits, emergency department visits, and readmissions were observed.
- Per-patient-year follow-up showed a decrease in outpatient visits but stable emergency visits and readmissions.
Conclusions:
- The number of patients receiving LVAD support is steadily increasing.
- This growing population necessitates specialized healthcare services.
- Effective management of LVAD patients requires careful consideration of healthcare resource utilization.
Background:
A left ventricular assist device (LVAD) is a life-saving but intensive therapy for patients with end-stage heart failure. We evaluated the healthcare consumption in a cohort of LVAD patients in our centre over 6 years.
Methods:
All patients with a primary LVAD implantation at the University Medical Centre Utrecht in Utrecht, the Netherlands from 2016 through 2021 were included in this analysis. Subsequent hospital stay, outpatient clinic visits, emergency department visits and readmissions were recorded.
Results:
During the investigated period, 226 LVADs were implanted, ranging from 32 in 2016 to 45 in 2020. Most LVADs were implanted in patients aged 40-60 years, while they were supported by or sliding on inotropes (Interagency Registry for Mechanically Assisted Circulatory Support class 2 or 3). Around the time of LVAD implantation, the median total hospital stay was 41 days. As the size of the LVAD cohort increased over time, the total annual number of outpatient clinic visits also increased, from 124 in 2016 to 812 in 2021 (p = 0.003). The numbers of emergency department visits and readmissions significantly increased in the 6‑year period as well, with a total number of 553 emergency department visits and 614 readmissions. Over the years, the annual number of outpatient clinic visits decreased by 1 per patient-year follow-up, while the annual numbers of emergency department visits and readmissions per patient-year remained stable.
Conclusion:
The number of patients supported by an LVAD has grown steadily over the last years, requiring a more specialised healthcare in this particular population.
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