Long-Term Healthcare Utilization, Medical Cost, and Societal Cost in Adult
Congenital Heart Disease

Willems, Ruben; Ombelet, Fouke; Goossens, Eva; Groote, Katya De; Budts, Werner; Moniotte, Stéphane; Hosson, Michèle de; Bulck, Liesbet Van; Marelli, Arianne; Moons, Philip; Backer, Julie De; Annemans, Lieven

doi:10.32604/chd.2020.011709

Cited by 6 publications

(5 citation statements)

References 34 publications

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“…The outcome of CHD after the follow-up period revealed that almost 40% of patients with depression suffered from deteriorated health and that 60% had improved based on their cardiac parameters by echo and enzyme measurements. This finding is slightly lower than that of Willems R. et al, who reported that following their initial CHD-related admittance, 79% of people with CHD continued to go labour market with improved health [32]. The difference may be in the follow-up period; the follow-up was 3 months in our study and one year in the comparative study.…”

Section: Discussioncontrasting

confidence: 83%

Depression: a predictor of coronary heart disease in Saudi Arabia

Alshahrani¹,

Korairi²,

Sharifi³

et al. 2022

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Aims and Objectives: This research study mainly deals to evaluate the effect of depression in coronary heart disease patients. Background: Depression is one of the common comorbidity among patients presented with acute coronary syndrome or those with major cardiovascular event. Depression has been independently associated or lead to acute cardiac events in patients. Method: The study was conducted from three months followed-up patients with recent diagnosed coronary heart disease and they getting treatment from cardiac centres “Armed Forces Hospitals. Depression was evaluated by using 17-item Hamilton Rating Scale and the cardiac outcome was assessed clinically by echo parameters and cardiac biomarkers such as C-reactive Protein. The data were analysis by SPSS version 23. Results: In this study 83 patients were part of this research. The patients had been picked up from range 18-65 year in which mostly patients were male (75%) than female (25%). Among 83 coronary heart disease patients 29.5% were suffering from depression while 19.5% were on severity. The deterioration factor was significantly influence by depression and smoking. Conclusion: Depression has a great impact on deterioration of the cardiac outcomes. It can serve as a predictive variable for future cardiological morbidity and mortality.

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Section: Discussioncontrasting

confidence: 83%

Depression: a predictor of coronary heart disease in Saudi Arabia

Alshahrani¹,

Korairi²,

Sharifi³

et al. 2022

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“… 36–38 A previous BELCODAC study reported that, in 2015, 21% of patients visited a physician for adults with CHD, 86% had a GP visit, 17% of patients had an ED visit, and 17% were hospitalized at least once. 38 On top of that, we know from studies in other chronic patient populations that healthcare utilization increases in the last months of life, mainly as a response to the presence of comorbidities and exacerbations at the end of life. 39 Referral to palliative care has shown to decrease the number of inpatient stays and ICU admissions at the end of life.…”

Section: Discussionmentioning

confidence: 99%

Last year of life of adults with congenital heart diseases: causes of death and patterns of care

Bulck

Goossens

Morin

et al. 2022

European Heart Journal

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Background and aims Although life expectancy in adults with congenital heart diseases (CHD) has increased dramatically over the past five decades, still a substantial number of patients dies prematurely. To gain understanding in the trajectories of dying in adults with CHD, the last year of life warrants further investigation. Therefore, our study aimed to (i) define the causes of death, and (ii) describe the patterns of healthcare utilisation in the last year of life of adults with CHD. Methods and Results This retrospective mortality follow-back study used healthcare claims and clinical data from BELCODAC, which includes patients with CHD from Belgium. Healthcare utilisation comprises cardiovascular procedures, CHD physician contacts, general practitioner visits, hospitalisations, emergency department (ED) visits, intensive care unit (ICU) admissions, and specialist palliative care and was identified using nomenclature codes. Of the 390 included patients, almost half of the study population (45%) died from a cardiovascular cause. In the last year of life, 87% of patients were hospitalised, 78% of patients had an ED visit, and 19% of patients had an ICU admission. Specialist palliative care was provided to 17% of patients, and to only 4% when looking at the patients with cardiovascular causes of death. Conclusions There is a high use of intensive and potentially avoidable care at the end of life. This may imply that end-of-life care provision can be improved. Future studies should further examine end-of-life care provision in the light of patient’s needs and preferences, and how the healthcare system can adequately respond.

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“…Currently, access to neuropsychological services for people with complex CHD in Australia is limited and costly [ 58 ], which compounds the high financial burden associated with having a complex cardiac condition [ 59 ]. Minimizing socioeconomic barriers that limit access to neuropsychological services for people with complex CHD is becoming a recognized health priority [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study

Verrall,

Tran,

Kasparian

et al. 2024

Pediatr Cardiol

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Adults with complex congenital heart disease (CHD) are at risk for cognitive dysfunction. However, associations between cognitive dysfunction and psychosocial outcomes are poorly defined. Between June and November 2022, we prospectively recruited 39 adults with complex CHD who completed a computerized cognitive assessment (Cogstate) and validated psychosocial scales measuring psychological distress, health-related quality of life (HRQOL), and resilience. Participants had a mean age of 36.4 ± 11.2 years. Over half (62%) were women, most (79%) had complex biventricular CHD, and 21% had Fontan physiology. Prevalence of cognitive dysfunction was greatest in the domains of attention (29%), working memory (25%), and psychomotor speed (21%). Adjusting for age and sex, Pearson partial correlations between Cogstate z-scores and self-reported cognitive problems were small. Participants who lived in the most disadvantaged areas and those with a below-average annual household income had lower global cognitive z-scores (p = 0.02 and p = 0.03, respectively). Two-thirds (64%) reported elevated symptoms of depression, anxiety, and/or stress. Small correlations were observed between psychological distress and cognitive performance. Greater resilience was associated with lower psychological distress (r ≥ −0.5, p < 0.001) and higher HRQOL (r = 0.33, p = 0.02). Our findings demonstrate that adults with complex CHD have a high risk of cognitive dysfunction, though may not recognize or report their cognitive challenges. Lower socioeconomic status may be an indicator for those at risk of poorer cognitive functioning. Psychological distress is common though may not be a strong correlate of performance-based cognitive functioning. Formal cognitive evaluation in this patient population is essential. Optimizing resilience may be a protective strategy to minimize psychological distress and bolster HRQOL.

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Long-Term Healthcare Utilization, Medical Cost, and Societal Cost in Adult Congenital Heart Disease

Cited by 6 publications

References 34 publications

Depression: a predictor of coronary heart disease in Saudi Arabia

Depression: a predictor of coronary heart disease in Saudi Arabia

Last year of life of adults with congenital heart diseases: causes of death and patterns of care

Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study

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