Resource utilization and costs in heart failure

Background: Chronic systolic heart failure (CHF) is currently one of the most prevalent cardiac diseases. The present analysis sought to estimate the one-year disease-related resource use and associated management costs of patients with CHF. Data and Methods: 2,710 individuals with systolic heart failure (mean age 62.9 years±13.6, 25.2% female) were included from the German Competence Network Heart Failure. Disease-related resource use was assessed with regard to outpatient contacts to physicians, hospitalizations including rehabilitation stays, and drug utilization. Results: During one year, patients had on average 6.1 contacts to their general practitioner, 1.7 contacts to cardiologists and 0.8 hospital stays per year. Overall, care costs per patient were calculated at 3,150€ per year. The largest component related to hospitalizations (2,328€, 74%), while costs of rehabilitation (294€, 9%), medication (290€, 9%) and outpatient contacts (238€, 8%) were considerably lower. Compared with 2,474€ in NYHA class I, there was a cost increase in NYHA II, III and IV of 14%, 48%, and 71% respectively. About 76% of this cost increases resulted from augmented hospital (inpatient) resource use. Conclusion: The present analysis demonstrates a high resource consumption of heart failure care. In particular, patients in higher NYHA classes require increased inpatient resources. Hence, improved treatment strategies need to be developed to optimize care thus reducing hospitalization rates.