Baseline Patient-Reported Health Status Predicts Hospitalization Duration and Cost in Chronic Heart Failure

This study examined the significance and independence of patient-reported outcomes (PROs) in predicting hospitalization costs and duration among patients with chronic heart failure (CHF). This observational cross-sectional study included all adult patients with a physician-confirmed diagnosis of CHF who were admitted to the cardiology department of a university emergency hospital in Bucharest, Romania, between July and September 2024. Upon admission, patients completed the validated Romanian version of the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ) and underwent a clinical interview, physical examination, blood sampling, and transthoracic echocardiography. The primary outcomes were total hospitalization cost and length of stay, whereas the KCCQ Overall Summary Score (KCCQ-OSS) served as the primary predictor in generalized linear models adjusted for potential confounders. The study included 171 patients with a mean age of 73.5 years, of whom 55.0% were women. The median total hospitalization cost was €1,513 per patient, and the mean length of stay was 8.7 days. Each 10-point decrease in KCCQ-OSS was independently associated with a 9.5% increase in expected hospitalization duration, whereas each 10-point increase in KCCQ-OSS was independently associated with a 5.1% increase in expected hospitalization cost, likely reflecting elective procedures in healthier patients. The latter finding likely reflects that patients with better baseline health status were more often selected for elective or interventional procedures, which increased costs despite shorter stays. These results demonstrate that the KCCQ-OSS is an independent predictor of both hospitalization cost and duration in CHF, within the limits of the study (single-center, small sample). Incorporating KCCQ assessment into routine practice may enable earlier identification of high-risk, high-cost patients, inform resource allocation, and enhance patient-centered, value-based management strategies for CHF.