Costs and healthcare utilisation of patients with heart failure in Spain

Abstract

Background Increasing the knowledge about heart failure (HF) costs and their determinants is important to ascertain how HF management can be optimized, leading to a significant decrease of HF costs. This study evaluated the cumulative costs and healthcare utilisation in HF patients in Spain. Methods Observational, retrospective, population-based study using BIG-PAC database, which included data from specialized and primary care of people ≥18 years, from seven autonomous communities in Spain, who received care for HF between 2015 and 2019. The healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until 2019. Results We identified 17,163 patients with HF (year 2015: mean age 77.3 ± 11.8 years, 53.5% men, 51.7% systolic HF, 43.6% on NYHA functional class II). During the 2015–2019 period, total HF associated costs reached 15,373 Euros per person, being cardiovascular disease hospitalizations the most important determinant (75.8%), particularly HF hospitalizations (51.0%). Total medication cost accounted for 7.0% of the total cost. During this period, there was a progressive decrease of cardiovascular disease hospital costs per year (from 2834 Euros in 2015 to 2146 Euros in 2019, P < 0.001), as well as cardiovascular and diabetic medication costs. Conclusions During the 2015–2019 period, costs of HF patients in Spain were substantial, being HF hospitalizations the most important determinant. Medication costs represented only a small proportion of total costs. Improving HF management, particularly through the use of drugs that reduce HF hospitalization may be helpful to reduce HF burden.

Costs and healthcare utilisation of patients with chronic kidney disease in Spain

“…As a result, it automatically collects information from routine practice, without requiring manual inputting. Previous studies have demonstrated its representativeness of the Spanish population [ 21 , 22 ].…”

“…This database has been validated as an information source for studies of epidemiology, therapeutic adaptation and health/non-healthcare resource use and associated costs. It is representative of the Spanish population [ 21 ]. The study was approved by the Investigation Ethics Committee of Consorci Sanitari from Terrassa.…”

“…Informed consent was waived by the same ethics committee that approved the study, as this was a secondary data study and data were fully anonymized and dissociated from patients. All methods were performed in accordance with the relevant guidelines and current regulations [ 21 , 23 ].…”

“…Costs were not taken from BIG-PAC database. Data were calculated using sources from the Spanish National Healthcare System of 2019 (supplementary Table 2 ) and used for the overall study period [ 21 ]. The healthcare resource use and costs and medication and procedure costs were summarized on a yearly basis starting from index date (1st January 2015), and then cumulatively until the end of the last year of follow-up (31st December 2019).…”

“…The healthcare resource use and costs and medication and procedure costs were summarized on a yearly basis starting from index date (1st January 2015), and then cumulatively until the end of the last year of follow-up (31st December 2019). All hospital visits (total and cardiovascular events), medical and emergency room visits, medication costs, and procedure costs (total, dialysis, kidney transplant) were included for the analysis of the annual direct healthcare costs [ 21 ]. Costs per patient were calculated every year.…”