Understanding Total Costs Associated with Hospitalization for Heart Failure, with Veraprapas Kittipibul, MD

Hospitalization costs are higher for patients with heart failure (HF) with ejection fractions of ≤40% or >40%, but the contributing factors to these costs vary significantly across the ejection fraction spectrum.

The data, presented at the American College of Cardiology 2024 (ACC.24) Annual Scientific Session, cited the importance of heart failure therapeutics that reduce all-cause hospitalizations and HF hospitalization to offset increasing healthcare costs.¹

“I think we care a lot about hard outcomes, such as hospitalization, death, and even quality of life is becoming more and more important in heart failure,” explained Veraprapas Kittipibul, MD, cardiology and research fellow at Duke University Medical Center, in an interview with HCPLive. “But we cannot forget the cost asscoiated with [heart failure].”

Analyses occurred among Medicare beneficiaries in the Get With the Guidelines-HF registry, a large, contemporary US registry of patients hospitalized with heart failure, between 2016 and 2018. Kittipibul and colleagues assessed the mean per-patient total and cause-specific, unadjusted Medicare payments (Parts A & B) over a 12-month, post-discharge period.^1,2

Those with heart transplants or left ventricular assist devices (LVAD) were excluded from the analysis. For the analysis, Kittipibul and colleagues compared payments across the spectrum of ejection fraction. Among 87,427 patients included in this analysis, 31,032 (35%) had ejection fraction ≤40%, while 56,395 (65%) had EF >40%.¹

Investigators found the 12-month mortality was higher among patients with EF ≤40% (38.1% vs. 33.6%; P <.01) versus the EF >40% group. However, the total costs and all-cause hospitalization costs were high among both EF groups (total costs: $40,865 vs. $39,196; all-cause hospitalization: $23,922 vs. $22,059), with all-cause hospitalization bearing the greatest burden of expenses.¹

Moreover, analyses showed patients with EF ≤40% incurred higher costs from cardiovascular ($13,539 vs $9,229) and HF ($8,194 vs $4,979) hospitalizations, but lower costs from skilled nursing facilities ($3635 vs. $4606), compared with those with EF >40%.¹

In an interview with HCPLive at ACC.24, Kittipibul described the key takeaways from the data and how they demonstrate the importance of implementation science to reduce HF-related hospitalizations.

Kittipibul has no relevant disclosures to report.

References:

1. Kittipibul V, Vaduganathan MV, Fonarow GC, et al. TOTAL AND CAUSE-SPECIFIC HEALTHCARE COSTS FOLLOWING HOSPITALIZATION FOR HEART FAILURE WITH REDUCED VS MILDLY REDUCED/PRESERVED EJECTION FRACTION. Presented at: American College of Cardiology (ACC.24) Annual Scientific Session. April 6 – 8, 2024. Atlanta, GA.
2. American Heart Association. Get with the guidelines® - heart failure registry tool. www.heart.org. December 12, 2023. Accessed April 7, 2024. https://www.heart.org/en/professional/quality-improvement/get-with-the-guidelines/get-with-the-guidelines-heart-failure/get-with-the-guidelines-hf-registry-tool.