Abstract
BackgroundCongestive heart failure (CHF) is among the most common causes of hospital admissions and readmissions in the Western world. However, the burden of ambulatory care has not been as well investigated. The objective of this study was to assess the relative burden and direct medical costs of CHF including inpatient and outpatient care.MethodsWe used longitudinal clinical data from a two-million member health organization in Israel (Maccabi Healthcare Services) to identify adults with newly diagnosed CHF between January 2006 and December 2012, either in the in- or outpatient setting. Adults without CHF were age- and sex-matched to CHF patients and healthcare utilization and all modes of healthcare costs were compared among them, excluding those in their last year of life.ResultsThe burden posed by 6592 CHF patients was significantly (p < 0.001) larger than that of 32,960 matched controls. CHF patients had significantly higher rates of baseline comorbidity and healthcare utilization compared to non-CHF controls. This was evident in all categories of healthcare services and expenses, including in- and outpatient visits, laboratory expenses, medication costs, among younger and older, men and women. Among those who incurred any healthcare costs, younger (45-64y) and older (65 + y) subjects with CHF were observed to have about 3.25 (95% CI: 2.96–3.56) and 2.08 (95% CI: 1.99–2.17) times the healthcare costs, respectively, compared to subjects without CHF after adjusting for patient characteristics.ConclusionCHF is associated with an overall two- to three-fold higher cost of healthcare services depending on patient age, accounting for over half of all healthcare costs incurred by elderly CHF patients, and more than two-thirds of all costs among younger CHF patients. Observations of the large burden posed on one of the youngest societies in the developed world are profound, implicative of great opportunities to control the costs of CHF. Further research to understand how resource use impacts health outcomes and quality of care is warranted.
Highlights
Congestive heart failure (CHF) is among the most common causes of hospital admissions and readmissions in the Western world
A total of 6,592 CHF patients surviving at least 1 year from diagnosis were compared to 32,960 age- and sex-matched Maccabi Healthcare Services (MHS) members without a diagnosis of CHF who had at least 1 year of enrollment in MHS and were members for at least 1 year after index
The results of the present analysis show that CHF is associated with substantial healthcare utilization and costs incurred during the year following diagnosis, despite the relatively young population of Israel (MHS median age 42 (Appendix 1))
Summary
Congestive heart failure (CHF) is among the most common causes of hospital admissions and readmissions in the Western world. The objective of this study was to assess the relative burden and direct medical costs of CHF including inpatient and outpatient care. Congestive heart failure (CHF) is a major source of morbidity and mortality and is associated with both substantial health and economic costs. The prevalence of CHF among the adult population in the developed world is approximately 1–2%, rising to more than 10% among persons 70 years of age or older [1]. Prognosis among heart failure patients is not promising, with 1 year mortality rates of 28% observed in a local heart failure population [5]. Thereafter, the mortality is near 10% per year according to English registry data
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
