Abstract P116: Hospitalization Due to Heart Failure is Associated With Significant Medical Resource Utilization and Costs
Authors: Korves Caroline , McHale Joshua , Lafeuille Marie-Helene , Ariely Rinat , Duh Mei Sheng 
Published: July 2021

Background:
The study objective was to describe treatment patterns, medical resource utilization and costs following hospitalization for different types of heart failure (HF).

Methods:
Patients(pts) with ≥1 hospitalization with a HF claim (ICD-9 428.xx) were identified in a large US commercial insurance claims database from 2004-2008. Pts were followed from 1
st
day of hospitalization for HF until disenrollment or end of data availability. Diagnostics, procedures, and Rx drugs were used to estimate utilization rates. Rates of hospital admissions due to HF and outpatient visits were calculated. Cost data included actual payments made by insurers standardized to 2008 USD; per pt per month costs were calculated. Results were stratified by systolic, diastolic, acute and chronic HF.

Results:
Analysis included 278,307 (mean age 73.1 years, 50.5% male) pts with ≥1 hospitalization for HF of any kind, including 20,938 (7.5%) pts with systolic HF, 19,304 (6.9%) with diastolic HF, 14,533 (5.2%) with acute HF and 7,814 (2.8%) with chronic HF at 1
st
hospitalization. Following 1
st
hospitalization, the rate of cardiac diagnostics, and cardiac surgeries/procedures was 10.3 and 0.064 per person-year, respectively. Across the 4 HF types, rates of cardiac surgeries/procedures varied from 0.055 for diastolic to 0.091 per person-year for systolic HF. The 1
st
HF hospitalization had a mean length of stay of 7.6 days, similar to 7.7 days in subsequent HF hospitalizations. The HF admission rate was 1.8 per pt-year with 44% occurring within 3 months of 1
st
hospitalization (4.84 hospitalizations per pt-year in 3 months vs. 0.23 in 18-24 months). The
table
shows that costs for inpatient and outpatient services tended to be higher in systolic and acute HF pts.

Conclusions:
The findings of this large cohort of over 250,000 hospitalized HF pts indicate that HF is resource-intensive. Greatest resource utilization was for systolic HF, acute HF and during the 3 months following 1
st
HF hospitalization.

All HF (N=278,307) cost per pt per month 2008 USD (mean SD)
Systolic HF (N=20,938) cost per pt per month 2008 USD (mean SD)
Diastolic HF (N=19,304) cost per pt per month 2008 USD (mean SD)
Acute HF (N=14,533) cost per pt per month 2008 USD (mean SD)
Chronic HF (N=7,814) cost per pt per month 2008 USD (mean SD)

Inpatient visits for HF
$4,289 (36,073)
$4,875 (31,873)
$3,766 (24,426)
$4,509 (26,655)
$4,372 (23,838)

Diagnostics
$47 (398)
$64 (443)
$42 (268)
$64 (438)
$44 (286)

Cardiac surgeries and procedures
$27 (503)
$36 (513)
$14 (195)
$37 (558)
$29 (496)

Outpatient visits
$764 (3,263)
$769 (3,195)
$737 (2,279)
$785 (3,345)
$708 (2,204)

Diagnostics
$33 (205)
$43 (277)
$32 (158)
$38 (165)
$39 (367)

Cardiac surgeries and procedures
$4 (137)
$5 (93)
$2 (34)
$5 (91)
$3 (51)

Pharmacy
$294 (540)
$292 (455)
$314 (520)
$296 (471)
$300 (463)

Cardiovascular disease drugs
$42 (76)
$51 (74)
$41 (62)
$46 (61)
$49 (67)

Other drugs
$252 (514)
$242 (436)
$273 (504)
$250 (455)
$251 (444)