PDB124 BURDEN OF HEART FAILURE IN PATIENTS WITH DIABETES IN ENGLAND

Abstract

Heart failure (HF) and diabetes independently carry a significant cost to the UK National Health Service (NHS). This may increase among patients with both diseases; HF hospitalisation rates may be higher as prognosis is poor. This cross-sectional study aims to characterise the healthcare burden of comorbid HF and diabetes. We identified patients admitted to hospital in England with a primary diagnosis of HF (ICD-10 Codes I500, I501, I509) and a secondary diagnosis of diabetes (E10-E14) from Hospital Episode Statistics for 3 consecutive years, 2015/16, 2016/17 & 2017/18. We report the total number of inpatient admissions, inpatient costs, 90 day re-admissions, inpatient length of stay, excess bed days, and inpatient mortality. In 2015/16, there were 30,236 inpatient admissions, costing a total of £99,748,586.95. In 2017/18 there were a total of 34,233 admissions costing a total of £127,601,295.77. Inpatient length of stay was 9.94 days in 2014/15 and 9.28 days in 2017/18. This varied across Clinical Commissioning Groups (CCGs) for all three years of observation. 7314 (24%) of the total admissions in 2015/16 were re-admitted within 90 days, this figure was 8,119 (24%) in 2017/18. In 2015/16 there were a total of 20,253 excess bed days across all admissions, in 2017/18 this was 14,930. Of all admissions in 2015/16 approximately 11% resulted in a patient death (N = 3,266), whereas in 2017/18 this was 10% (N = 3,510). Comorbid HF and diabetes pose a high cost to the NHS, with substantial variation within England. 90-day re-admission, excess bed days and inpatient mortality highlight the burden of these conditions. Further research is warranted to understand how hospital-level interventions may contribute to the effort to reduce these costs and improve inpatient mortality.