Relationship Between Heart Failure Hospitalization Costs and Left Ventricular Ejection Fraction in an Advanced Aging Society

Abstract

Background: Left ventricular ejection fraction (LVEF) is a basic clinical index that determines the heart failure (HF) treatment strategy. We aimed to evaluate the association between hospitalization costs for HF patient and LVEF in an advanced aging society in a region in Japan. Methods and Results: Consecutive HF patients admitted to Miyazaki Prefectural Nobeoka Hospital between January 2015 and March 2018 were included in the study. The 346 HF patients (mean age 78 years) were divided into 2 groups: HF with reduced ejection fraction (HFrEF; LVEF <40%; n=129) and HF with preserved ejection fraction (HFpEF; LVEF ≥40%; n=217). Median hospitalization costs (in 2017 US dollars) were higher in the HFrEF than HFpEF group, but the difference was not statistically significant ($7,128 vs. $6,580; P=0.189). However, in older adults (age ≥75 years; n=252), median hospitalization costs were significantly higher in the HFrEF than HFpEF group ($7,240 vs. $6,471; P=0.014), and LVEF was an independent factor of hospitalization costs (β=−0.0301, P=0.006). Median hospitalization costs were significantly lower in the older than younger HFpEF group ($6,471 vs. $7,250; P=0.011), but there was no significant difference in costs between the older and younger HFrEF groups ($7,240 vs. $6,760; P=0.351). Conclusions: The relationship between LVEF and hospitalization costs became more pronounced with age, and LVEF was a negative independent factor for hospitalization costs in the older population.

Evolution of economic burden of heart failure by ejection fraction in newly diagnosed patients in Spain

“…In other study performed in Spain, the proportion of patients among different HF subtypes clearly depending on the specialty that attended patients (i.e., internal medicine vs cardiology) [ 25 ]. These differences can be partly attributable to the proportion of patients with unknown EF in each study, the age of their patients, and the clinical setting in which patients are attended [ 3 , 4 , 12 , 14 , 25 , 26 ]. However, as the BIG-PAC database collected information from electronic medical records of both inpatient and outpatient settings from hospital specialties and primary care in seven different Autonomous Communities in Spain, the information provided was balanced, comprehensive and with a lower risk of bias, supporting that the results can be extended to the whole Spanish population [ 1 , 11 , 18 ].…”

Prediction of intracerebral hemorrhage in patients with out-of-hospital cardiac arrest using post-resuscitation electrocardiogram: An observational cohort study

“…Miyazaki Prefectural Nobeoka Hospital is the only regional high-quality resuscitation hospital designated by the municipal government. 14 , 15 , 16 , 17 It provides most of the medical care for this population. In the city, emergency medical services transfer all patients without a pre-existing terminal disease who have experienced OHCA to this hospital.…”

Healthcare resource utilization and costs among patients with heart failure with preserved, mildly reduced, and reduced ejection fraction in Spain

“…Although some studies have analyzed the clinical pro le and management of HF strati ed by EF (HFrEF, HF with mildly reduced EF [HFmrEF] and HFpEF) [19][20][21], there are very few studies that have focused on identifying cost drivers according to HF phenotype [22][23][24][25].…”