Economic impact of heart failure in Brazil

Heart failure (HF) is highly prevalent worldwide and is the main cause of hospitalisations in developed countries. It is the leading cause of hospitalisations for cardiovascular diseases in Brazil, which places a substantial burden on the Unified Health System. We aimed to evaluate public healthcare expenditures for patients diagnosed with HF and those potentially at risk of developing the condition.

We used data from the DATASUS database, which encompasses information from the Brazilian Unified Health System (Sistema Único de Saúde (SUS)). We utilised the Outcome Information System Ambulatory - SUS (Sistema de Informações Hospitalares do SUS (SIA-SUS)) and the Hospital Information System - SUS (Sistema de Informações Hospitalares do SUS (SIH-SUS)) systems. After evaluating public health expenditures for patients with or at risk of developing HF, we analysed the distribution of these expenditures according to demographic factors and clinical characteristics to determine the financial impact on the healthcare system and its relationship with different patient profiles.

The SIA-SUS comprised 354 171 patients diagnosed with HF, while the SIH-SUS contributed 708 161 patients as a potential HF group. We linked 67 539 patients from SIA-SUS and SIH-SUS due to the need for a proxy identifier. Overall, potential HF patients incurred higher costs than diagnosed HF patients, with this disparity being particularly evident in hospital-related expenses. From 2018 to 2019, the average costs for potential HF patients were 1.7 times greater than those for diagnosed HF patients. Potential HF patients incurred the highest cost per patient across all age groups, with those ≤44 years old incurring the highest costs (USD 501.04), followed by those 45-64 years old (USD 488.76). Group diagnosed with HF, patients aged 45-64 years incurred the highest costs (USD 419.89), followed by those aged ≥65 (USD 330.02). Males incurred the highest costs in both diagnosed and potential HF groups.

The burden of potential HF was higher than diagnosed HF, showed by greater public healthcare expenditures. Understanding the cost of this disease is important for informing resource allocation and the implementation of more effective measures for the population with HF.