Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain
Abstract Aims To describe healthcare resource utilization (HCRU) of patients with heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF) in Spain. Methods Adults with ≥ 1 HF diagnosis and ≥ 1 year of continuous enrolment before the corresponding index d...
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-08614-x |
| _version_ | 1797996057291915264 |
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| author | Carlos Escobar Beatriz Palacios Luis Varela Martín Gutiérrez Mai Duong Hungta Chen Nahila Justo Javier Cid-Ruzafa Ignacio Hernández Phillip R. Hunt Juan F. Delgado |
| author_facet | Carlos Escobar Beatriz Palacios Luis Varela Martín Gutiérrez Mai Duong Hungta Chen Nahila Justo Javier Cid-Ruzafa Ignacio Hernández Phillip R. Hunt Juan F. Delgado |
| author_sort | Carlos Escobar |
| collection | DOAJ |
| description | Abstract Aims To describe healthcare resource utilization (HCRU) of patients with heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF) in Spain. Methods Adults with ≥ 1 HF diagnosis and ≥ 1 year of continuous enrolment before the corresponding index date (1/January/2016) were identified through the BIG-PAC database. Rate per 100 person-years of all-cause and HF-related HCRU during the year after the index date were estimated using bootstrapping with replacement. Results Twenty-one thousand two hundred ninety-seven patients were included, of whom 48.5% had HFrEF, 38.6% HFpEF and 4.2% HFmrEF, with the rest being of unknown EF. Mean age was 78.8 ± 11.8 years, 53.0% were men and 83.0% were in NYHA functional class II/III. At index, 67.3% of patients were taking renin angiotensin system inhibitors, 61.2% beta blockers, 23.4% aldosterone antagonists and 5.2% SGLT2 inhibitors. Rates of HF-related outpatient visits and hospitalization were 968.8 and 51.6 per 100 person-years, respectively. Overall, 31.23% of patients were hospitalized, mainly because of HF (87.88% of total hospitalizations); HF hospitalization length 21.06 ± 17.49 days (median 16; 25th, 75th percentile 9–27). HF hospitalizations were the main cost component: inpatient 73.64%, pharmacy 9.67%, outpatient 9.43%, and indirect cost 7.25%. Rates of all-cause and HF-related HCRU and healthcare cost were substantial across all HF subgroups, being higher among HFrEF compared to HFmrEF and HFpEF patients. Conclusions HCRU and cost associated with HF are high in Spain, HF hospitalizations being the main determinant. Medication cost represented only a small proportion of total costs, suggesting that an optimization of HF therapy may reduce HF burden. |
| first_indexed | 2024-04-11T10:11:25Z |
| format | Article |
| id | doaj.art-1e346887883241cca4bd4817e2403de7 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T10:11:25Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-1e346887883241cca4bd4817e2403de72022-12-22T04:30:06ZengBMCBMC Health Services Research1472-69632022-10-0122111610.1186/s12913-022-08614-xHealthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in SpainCarlos Escobar0Beatriz Palacios1Luis Varela2Martín Gutiérrez3Mai Duong4Hungta Chen5Nahila Justo6Javier Cid-Ruzafa7Ignacio Hernández8Phillip R. Hunt9Juan F. Delgado10Cardiology Department, University Hospital La PazAstraZeneca FarmaceuticaAstraZeneca FarmaceuticaAstraZeneca FarmaceuticaEvideraAstraZenecaEvidera, Stockholm, Sweden; Karolinska Institute, Department of Neurobiology, Care Sciences, and SocietyEvideraAtrys HealthAstraZenecaCardiology Department, University Hospital 12 de Octubre, CIBERCVAbstract Aims To describe healthcare resource utilization (HCRU) of patients with heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF) in Spain. Methods Adults with ≥ 1 HF diagnosis and ≥ 1 year of continuous enrolment before the corresponding index date (1/January/2016) were identified through the BIG-PAC database. Rate per 100 person-years of all-cause and HF-related HCRU during the year after the index date were estimated using bootstrapping with replacement. Results Twenty-one thousand two hundred ninety-seven patients were included, of whom 48.5% had HFrEF, 38.6% HFpEF and 4.2% HFmrEF, with the rest being of unknown EF. Mean age was 78.8 ± 11.8 years, 53.0% were men and 83.0% were in NYHA functional class II/III. At index, 67.3% of patients were taking renin angiotensin system inhibitors, 61.2% beta blockers, 23.4% aldosterone antagonists and 5.2% SGLT2 inhibitors. Rates of HF-related outpatient visits and hospitalization were 968.8 and 51.6 per 100 person-years, respectively. Overall, 31.23% of patients were hospitalized, mainly because of HF (87.88% of total hospitalizations); HF hospitalization length 21.06 ± 17.49 days (median 16; 25th, 75th percentile 9–27). HF hospitalizations were the main cost component: inpatient 73.64%, pharmacy 9.67%, outpatient 9.43%, and indirect cost 7.25%. Rates of all-cause and HF-related HCRU and healthcare cost were substantial across all HF subgroups, being higher among HFrEF compared to HFmrEF and HFpEF patients. Conclusions HCRU and cost associated with HF are high in Spain, HF hospitalizations being the main determinant. Medication cost represented only a small proportion of total costs, suggesting that an optimization of HF therapy may reduce HF burden.https://doi.org/10.1186/s12913-022-08614-xCostHeart failureHealthcare resource utilizationHospitalizationSacubitril/valsartanSGLT2 inhibitors |
| spellingShingle | Carlos Escobar Beatriz Palacios Luis Varela Martín Gutiérrez Mai Duong Hungta Chen Nahila Justo Javier Cid-Ruzafa Ignacio Hernández Phillip R. Hunt Juan F. Delgado Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain BMC Health Services Research Cost Heart failure Healthcare resource utilization Hospitalization Sacubitril/valsartan SGLT2 inhibitors |
| title | Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain |
| title_full | Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain |
| title_fullStr | Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain |
| title_full_unstemmed | Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain |
| title_short | Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain |
| title_sort | healthcare resource utilization and costs among patients with heart failure with preserved mildly reduced and reduced ejection fraction in spain |
| topic | Cost Heart failure Healthcare resource utilization Hospitalization Sacubitril/valsartan SGLT2 inhibitors |
| url | https://doi.org/10.1186/s12913-022-08614-x |
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