- •Costs associated with heart failure hospitalizations in the United States vary greatly among hospitalized patients
- •Biggest comorbidity contributors to increased inpatient costs are pulmonary disorders, valvular heart disease, and bleeding
- •Invasive procedures are common in patients hospitalized with heart failure and significantly increase hospitalization costs
- •Heart Failure readmissions are frequent, and readmissions also significantly contribute to total hospitalization costs
Heart failure hospitalizations are a major financial cost to healthcare systems. This study aimed to evaluate the costs associated with inpatient hospitalization.
Patients with a primary diagnosis of heart failure during a hospital admission between 2010 and 2014 in the U.S. Nationwide Readmission Database were included. The primary outcome was total cost defined by direct cost of index admission and first readmission within 30-days.
A total of 2,645,336 patients with primary heart failure were included in the analysis. The mean ± SD total cost overall was $13,807 ± 24,145; with mean total costs of $15,618 ± 25,264 for patients with 30-day readmission and $11,845 ± 22,710 for patients without a readmission. The comorbidities strongly associated with increased cost were pulmonary circulatory disorder (OR 26.24 95% CI 20.06–34.33), valvular heart disease (OR 25.42 95% CI 20.65–31.28) and bleeding (OR 5.96 95% CI 5.47–6.50). Among hospitalized patients, 12.6% underwent an invasive diagnostic procedure or treatment. The mean cost for patients without invasive care was $10,995. This increased by $129,547, $119,769, $251,110 and $293,575 for receipt of circulatory support, intra-aortic balloon pump, LV assist device and heart transplant. The greatest mean additional cost annually was associated with receipt of coronary angiogram ($26,282 per person for a total of ($728.5 million) and mechanical ventilation ($54,529 per person for a total of $501.7 million).
In conclusion, the costs associated with inpatient heart failure care are significant, and the major contributors to inpatient costs are comorbidities, invasive procedures and readmissions.
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Published online: December 12, 2020
Accepted: December 5, 2020
Received in revised form: November 16, 2020
Received: October 10, 2020
© 2020 Elsevier B.V. All rights reserved.
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- PreviewIn the United States, the prevalence of heart failure (HF) is expected to rise from 2.4% in 2012 to 3.0% in 2030 . This increase is related to the growing number of elderly individuals and the longer survival of many cardiac and noncardiac conditions possibly leading to HF development or decompensation. HF puts a significant strain on healthcare systems, and the overall cost of HF continues to rise . In 2012, the total cost for HF was estimated to be $31 billion, and projections suggest that the total cost of HF will increase by 127% by 2030, to $70 billion, amounting to $244 for every US adult .