PCV17: QUALITY OF LIFE AND PATIENT PREFERENCE AS PREDICTORS FOR RESOURCE UTILIZATION AMONG PATIENTS WITH HEART FAILURE; INTERIM ANALYSIS

Abstract

OBJECTIVE: The objective of this study was to examine the role of quality of life (QOL) and patient preference as predictors for resource utilization among patients with heart failure (HF). METHODS: QOL, patient preference, resource utilization, and survival are being assessed in 94 patients with HF managed in an urban HF specialty clinic. QOL is measured using a disease-specific questionnaire, the Kansas City Cardiomyopathy Questionnaire (KCCQ) and a generic questionnaire, the Short Form 12 (SF-12), at baseline, 3 months, and 6 months. Patient preference is measured using standard gamble technique at baseline. Resource use including hospitalization, ER visits, procedures, and outpatient visits are captured by patient interview and verified by clinic and hospital records. Health care costs are derived from clinic cost data, University Health System Consortium database, and literature. RESULTS: To date, 81 patients have completed 3 months follow-up (mean age 49.9 ± 14.0 years; 69% African American; 53% male; NYHA class I = 15, II = 24, III = 38; mean left ventricular ejection fraction = 34.3%± 15.5). Mean disease-specific QOL (KCCQ Overall Summary Score = 66.9) and generic QOL (Physical Component Summary = 38.7; Mental Component Summary = 48.2) were similar to literature values for HF patients. Mean utility was 0.832. Using linear regression, lower KCCQ scores, SF-12 scores, and utility at baseline were all significantly associated with higher resource utilization at 3 months. When patients were grouped into three categories based on their baseline KCCQ Overall Summary Score (I = 0–50, II => 50 to £75, III => 75), resource utilization over 3 months was significantly different across the groups (I = $4033; II = $2500; III = $2010; p = 0.0003). CONCLUSION: Among patients with HF, QOL and patient preference appear to predict future resource utilization.