Cardiology department hospitalization costs in patients with acute heart failure vary according to the etiology of the acute heart failure: Data from the AHEAD Core registry 2005-2009

Abstract

Background: To assess the distribution of costs associated with Cardiology Unit hospitalization due to acute heart failure (AHF) and evaluate, from the perspective of the healthcare payer, the heterogeneity of resources use according to AHF etiology in patients from 2005 to 2009. Methods: The type and etiology of AHF was determined upon hospital admission. The cost of in-patient care was based on the individual hospital account of each patient (1759 patients in total; 58.7% male; mean age 71 years). Results: The median hospital stay was 7 days and the mean total cost of in-patient care was €3364. A Coronary Care Unit (CCU) stay was recorded in 67.4% patients (median 3 days). Signifi cantly higher costs were found in de-novo AHF patients (mean €3678) with a greater need for CCU care, a longer stay in the CCU and a greater need for intervention (particularly that of percutaneous coronary intervention [PCI]), than in patients with acute decompensation of chronic heart failure (mean cost €2878; p < 0.001). Acute coronary syndrome was a major precipitating factor, with the highest costs (€4429) resulting from having received PCI (63.3% of patients) and CCU admission (91.7% of patients). Variations in length of stay according to AHF etiology were minor (median, 6-8 days). In-hospital mortality was 15.0%. Conclusions: Hospitalization costs as they relate to AHF are high, particularly in new-onset AHF patients. The heterogeneity of resources use is largely a refl ection of interventions undertaken, particularly if revascularization or anti-arrhythmic therapy is provided. SOUHRNCíl: Stanovení nákladů na hospitalizaci pacientů s akutním srdečním selháním (ASS) hospitalizovaných v letech 2005-2009 na kardiologické klinice z pohledu plátce zdravotní péče a následné zhodnocení heterogenity výdajů dle etiologie ASS. Metodologie: Typ ASS a jeho etiologie byla určena při přijetí pacienta na kliniku. Náklady na péči vycházejí z individuálního hospitalizačního účtu každého pacienta (celkem 1 759 pacientů; 58,7 % mužů; průměrný věk 71 let).

Metodología para analizar la carga financiera del cuidado familiar de una persona con enfermedad crónica

“…De los estudios reportados, el 32% fueron revisiones de bibliografía sobre el costo financiero de la EC (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28); el 4% fueron estudios cualitativos centrados en la percepción de costos por parte de los usuarios (29-31) y el 64 % restante se hicieron bajo abordaje cuantitativo. En este último grupo se encontraron metodologías variadas que son reportadas como: Aplicación o diseño de modelos (32)(33)(34)(35); comparación de cohortes (36); Análisis de costo efectividad o de ahorro (37,38); Análisis de costo beneficio o costo utilidad (39,40); Análisis del costo por utilización de servicios de salud (41)(42)(43)(44)(45); Comparación histórica de costos (46,47); Análisis de tendencia secular (48); Ensayo aleatorio controlado (49); Encuestas de gasto médico o de cuidado (50); Análisis retrospectivo de costos, revisión de costos en bases de datos u observación retrospectiva con comparación de costos (51)(52)(53); Estudio no aleatorio basado en la práctica (54); Técnicas de consenso y de instrumentación de manejo de caso a través de la identificación de insumos y funciones de producción para la demanda de cada servicio solicitado (55); Metodología de casos y controles; Estimación del costo social a partir de la sumatoria de los costos ambulatorio por paciente con los registros de gastos directos, indirectos y atribuibles al sistema (56); Cálculo de costos a partir del uso de ser...…”

Primary causes and direct medical cost of heart failure among adults admitted with acute decompensated heart failure in a public tertiary hospital, Kenya

“…Additionally, overall treatment cost among those who were hospitalised in CCU was twice as high as treatment cost in the general wards (Table 4). This would be because of increased resource utilisation following intensive care for critically ill patients with advanced stages of HF (43)(44)(45)(46)(47)(48)(49).…”