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Healthcare resource utilisation and costs associated with a heart failure diagnosis : A retrospective, population-based cohort study in Sweden
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- Boman, Kurt (author)
- Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, Res Unit, Med, Umeå, Sweden.
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- Lindmark, Krister (author)
- Umeå universitet,Kardiologi,Umeå Univ, Dept Publ Hlth, Umeå, Sweden.;Umeå Univ, Clin Med & Heart Ctr, Umeå, Sweden.
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- Stålhammar, Jan (author)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Olofsson, Mona, 1952- (author)
- Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, Res Unit, Med, Umeå, Sweden.
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- Costa-Scharplatz, Madlaina (author)
- Medical Affairs/RWE, Novartis Sweden AB, Stockholm, Sweden,Novartis Sweden AB, Med Affairs RWE, Stockholm, Sweden.
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- Fonseca, Ana Filipa (author)
- Novartis Pharma AG, Basel, Switzerland.
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- Johansson, Stina (author)
- IQVIA, Stockholm, Sweden.
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- Heller, Vincent (author)
- IQVIA, Solna, Sweden.
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- Törnblom, Michael (author)
- Real-World and Analytics Solutions, IQVIA Solutions Sweden AB, Solna, Sweden,IQVIA Solut Sweden AB, Real World & Analyt Solut, Solna, Sweden.
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- Wikström, Gerhard (author)
- Uppsala universitet,Klinisk epidemiologi
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(creator_code:org_t)
- 2021-10-19
- 2021
- English.
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:10
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Abstract
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- Objectives: To examine healthcare resource use (HRU) and costs among heart failure (HF) patients using population data from Sweden.Design: Retrospective, non-interventional cohort study.Setting: Two cohorts were identified from linked national health registers (cohort 1, 2005-2014) and electronic medical records (cohort 2, 2010-2012; primary/secondary care patients from Uppsala and Västerbotten).Participants: Patients (aged ≥18 years) with primary or secondary diagnoses of HF (≥2 International Classification of Diseases and Related Health Problems, 10th revision classification) during the identification period of January 2005 to March 2015 were included.Outcome measures: HRU across the HF phenotypes was assessed with logistic regression. Costs were estimated based on diagnosis-related group codes and general price lists.Results: Total annual costs of secondary care of prevalent HF increased from SEK 6.23 (€0.60) to 8.86 (€0.85) billion between 2005 and 2014. Of 4648 incident patients, HF phenotype was known for 1715: reduced ejection fraction (HFrEF): 64.5%, preserved ejection fraction (HFpEF): 35.5%. Within 1 year of HF diagnosis, the proportion of patients hospitalised was only marginally higher for HFrEF versus HFpEF (all-cause (95% CI): 64.7% (60.8 to 68.4) vs 63.7% (60.8 to 66.5), HR 0.91, p=0.14; cardiovascular disease related (95% CI): 61.1% (57.1 to 64.8) vs 60.9% (58.0 to 63.7), HR 0.93, p=0.28). Frequency of hospitalisations and outpatient visits per patient declined after the first year. All-cause secondary care costs in the first year were SEK 122 758 (€12 890)/patient/year, with HF-specific care accounting for 69% of the costs. Overall, 10% of the most expensive population (younger; predominantly male; more likely to have comorbidities) incurred ~40% of total secondary care costs.Conclusions: HF-associated costs and HRU are high, especially during the first year of diagnosis. This is driven by high hospitalisations rates. Understanding the profile of resource-intensive patients being at younger age, male sex and high Charlson comorbidity index scores at the time of the HF diagnosis is most likely a sign of more severe disease.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- adult cardiology
- health economics
- heart failure
- Cardiology
- kardiologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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Boman, Kurt
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Lindmark, Kriste ...
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Stålhammar, Jan
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Olofsson, Mona, ...
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Costa-Scharplatz ...
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Fonseca, Ana Fil ...
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Johansson, Stina
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Heller, Vincent
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Törnblom, Michae ...
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Wikström, Gerhar ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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BMJ Open
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Umeå University
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Uppsala University