Clinical InvestigationCongestive Heart FailureLong-term costs and resource use in elderly participants with congestive heart failure in the Cardiovascular Health Study☆
Section snippets
Methods
We assembled a study population from the participants of the National Heart, Lung, and Blood Institute CHS. The CHS is a prospective, community-based, epidemiologic, observational study of 5888 men and women aged 65 years or older from 4 geographically dispersed communities (Sacramento County, CA; Washington County, MD; Forsyth County, NC; and Allegheny County, PA).5, 6 The original cohort of 5201 participants was enrolled in 1989 to 1990 with a supplemental cohort of 687 mostly African
Results
There were 343 participants with prevalent HF at study entry (in 1992, the beginning of claims data) and 4517 participants without HF at study entry. Participants with HF were older (mean age, 78.2 vs 75.6 years; P < .0001) and more likely to be male (50.1% vs 41.2% in the nonprevalent HF group; P < .001) (Table I). As a group, the HF cohort had greater comorbid illness with significantly higher rates of hypertension (93.0% vs 67.8%; P < .05), diabetes (31.8% vs 17.2%; P < .05), and COPD (16.9%
Discussion
This is the first study to examine the longitudinal inpatient and outpatient costs of prevalent HF in the elderly. As expected, study participants with HF have higher costs and greater resource use during the 10-year study period. These differences are accentuated after adjusting for the worse survival of HF participants. However, after accounting for age, sex, and comorbidities, most of the greater costs seen with HF appeared to be explained by these comorbid conditions. In particular,
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2022, Public HealthCitation Excerpt :This study is a nationwide study investigating the healthcare cost system in Denmark and may not be directly applicable globally. Our analysis did not stratify by subtype or severity of HF, which potentially could have contributed with interesting findings as former studies have shown that the cost of HF increases with NYHA classes.18,26,27,29 Registry studies have inherent limitations associated with the data accuracy, but a registry validation study found a positive prediction value for HF is 81–84%, and the negative prediction value is 90% in the Danish registries.55,56
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2016, Progress in Cardiovascular DiseasesCitation Excerpt :The cost of nearly half of the hospitalizations for HF exceeds Medicare reimbursement, which places a significant financial burden on hospitals and healthcare systems.4 When compared to all hospitalized patients, those with HF incur greater health care costs through increased physician visits, hospital admissions, and twice as many days in intensive care units.4 End-stage HF as defined by ACC/AHA guidelines5 includes a subset of patients with HF who continue to have significant symptoms despite maximum goal directed medical therapy (GDMT).
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The Cardiovascular Health Study was funded by contracts NO1-HC-85079-85086 and NO1-HC-15103 from the National Heart, Lung and Blood Institute. This work was supported by a grant from the American Heart Association.