Burden of Chronic Heart Failure in Romania.

László Lorenzovici,Andrea Bârzan-Székely,Marcell Csanádi,Zoltán Kaló,Szabolcs Farkas-Ráduly,Nona Delia Chiriac,Bogdan C Pană

doi:10.3390/healthcare10010107

Abstract

Chronic heart failure (CHF) affects millions of people across the world, with increasing trends in prevalence, putting ever increasing pressure on the healthcare system. The aim of this study was to assess the financial burden of CHF hospital care on the public healthcare sector in Romania by estimating the number of inpatient episodes and the associated costs. Additionally, societal costs associated with missed work and premature death of CHF patients were also estimated. The national claims database was analyzed to estimate the number of CHF patients. Cost data was extracted from a pool of nine public hospitals in Romania. In 2019, 375,037 CHF patient episodes were identified on specific wards at the national level. The average cost calculated for the selected nine hospitals was EUR 996. The calculated weighted national average cost per patient episode was EUR 1002, resulting in a total cost of EUR 376 million at the national level. The cost of workdays missed summed up to EUR 122 million, while the annual costs associated with the premature death of CHF patients was EUR 230 million. In conclusion, the prevalence of CHF in Romania is high, accounting for a large proportion of hospitalizations, which translates into large costs for the national payer.

Highlights

Accepted: 3 January 2022Chronic heart failure (CHF), having a current prevalence of over 64.3 million people in the world [1], with increasing trends [2], is considered one of the most common diseases [3]
In order to assess the volume of care for CHF patient episodes in Romanian public hospitals, anonymized digital records were used, containing the data of discharged patients reported to the National Health Insurance House (NHIH) for reimbursement purposes for the year 2019
According to the 2019 data, there have been 590,730 CHF patient episodes reported to the NHIH for reimbursement purposes, of which 375,037 CHF patient episodes met our inclusion criteria from the studied departments

Summary

Introduction

Accepted: 3 January 2022Chronic heart failure (CHF), having a current prevalence of over 64.3 million people in the world [1], with increasing trends [2], is considered one of the most common diseases [3]. 1 and 2% in Europe [7], with five of the six countries with the highest age-standardized prevalence rates of HF being located in Central-Eastern Europe [8]. The high prevalence of the illness and the associated costs account for a substantial economic burden on the healthcare systems. Studies show costs associated with the hospitalization of CHF patients of USD 24,383 per patient in the US [13], USD 10,123 in Canada [14], EUR 2146 in Spain [15], USD 639 in Poland [16], USD 2285 in Sweden [17], EUR 5900 in Italy [18], and EUR 2854 in Ireland [19]. Reviews show that the proportion of inpatient costs of the total costs vary from one country to another and is between 47% and 96% [20]

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