Real-world healthcare utilization in adult congenital heart disease: a systematic review of trends and ratios

Abstract

Background:As a result of medical advances, the adult congenital heart disease population is rapidly expanding. Nonetheless, most patients remain prone to increased morbidity and mortality. Therefore, long-term medical resource use is required. This systematic review aims to present the trends over the past decades of medical resource utilization in adult congenital heart disease as well as its current status, with a focus on hospitalizations, emergency department visits, outpatient cardiology visits, and visits to other healthcare professionals.Methods:MEDLINE (Pubmed), Embase, and Web of Science were searched for retrospective database research publications. The ISPOR checklist for retrospective database research was used for quality appraisal. Trends over time are explored.Results:Twenty-one articles met the inclusion criteria. All but one of the studies was conducted in Western Europe and North America. The absolute number of hospitalizations has been increasing over the last several decades. This increase is highest in patients with mild lesions, although these numbers are largely driven by hospitalizations of patients with an atrial septal defect or a patent foramen ovale. Meanwhile, outpatient cardiology visits are increasing at an even higher pace, and occur most often in geriatric patients and patients with severe lesions. Conversely, the number of hospitalizations per 100 patients is decreasing over time. Literature is scarce on other types of healthcare use.Conclusion:A strong rise in healthcare utilization is noticed, despite the mitigating effect of improved efficiency levels. As the population continues to grow, innovative medical management strategies will be required to accommodate its increasing healthcare utilization.

Outcomes and healthcare resource utilization in adult congenital heart disease patients with heart failure

“…30 Given the increasing numbers and ages of ACHD patients, the demand for healthcare will only increase. 4 , 10 , 33 , 34 Future studies are needed to develop specific pathways to optimize HF care in these patients such that comprehensive management is provided at every HF stage. 35 , 36 …”

“…9 However, few studies have reported the contemporary outcomes of ACHD patients after a first hospitalization with HF. 10 , 11 , 12 , 13 , 14 Such data are needed as it would improve allocation of resources and management of these patients.…”

Prognostic Value of Serial High-Sensitivity Troponin T Measurements in Adults With Congenital Heart Disease

“…Both the need for life-long monitoring and the increased prevalence of patients with ACHD 3 have resulted in an increased health care utilization. 4 To be able to maintain an adequate and sustainable management of patients with ACHD, noninvasive, objective, and accurate methods to monitor patients are needed. Easily accessible blood biomarkers may be useful in this respect.…”

Illness identity in adults with congenital heart disease: Longitudinal trajectories and associations with patient‐reported outcomes and healthcare use

“…Over the past decades, the absolute number of hospitalizations and outpatient cardiology visits has expanded, showing high and changing healthcare demands for this population. These changes will put an increased burden on the healthcare system and society (Willems et al, 2019). To reduce this, a good understanding of the predictors of high healthcare use is needed.…”