Publication details

Chronic heart failure - Impact of the condition on patients and the healthcare system in the Czech Republic: A retrospective cost-of-illness analysis

Authors

PAVLUŠOVÁ Marie KLIMES Jiří ŠPINAR Jindřich ZEMAN Kamil JARKOVSKÝ Jiří BENEŠOVÁ Klára MIKLÍK Roman POHLUDKOVÁ Ludmila FELŠŐCI Marián VESELÁ Věra BLAHOVCOVÁ Michaela DOSTÁL Filip VONKA Richard PAŘENICA Jiří

Year of publication 2018
Type Article in Periodical
Magazine / Source cor et Vasa
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.crvasa.2018.03.002
Keywords Chronic heart failure; Hospitalization costs; Cost-of-illness
Description Background: The number of patients with heart failure is steadily increasing, as are the costs of their treatment. Nearly 70% of the costs associated with the treatment of heart failure are direct medical costs, and 70-80% of these are spent on hospitalizations. The aim of our study is to describe the all-cause hospitalization costs of patients with chronic heart failure (chronic HF) from the perspective of the healthcare system in the Czech Republic. Methods: In total, 1274 consecutively collected patients discharged in a stable condition from hospitalization for acute heart failure (= index hospitalization) from 2006 to 2012 were followed-up for 2 years. Their all-cause mortality and all-cause hospitalizations were retrospectively evaluated. The in-patient costs were calculated based on the relative weights of DRG codes for particular hospitalization events and on the basic DRG tariff for 2013 (CZK 28,898). Results: At the end of the 2-year follow-up, a total of 1511 hospitalizations were recorded. A total of 31.8% of patients survived without any hospitalization, 32.1% of patients survived with at least one hospitalization, and 36.1% of patients died. Re-hospitalizations for acute heart failure accounted for 31.2% of all cases. The average cost for one chronic HF patient hospitalized for any reason was CZK 85,414; the cost for acute heart failure re-hospitalization was CZK 31,320 during the 2-year follow-up period. The cost of all-cause hospitalizations within the first year after the index hospitalization was higher compared to the cost during the second year (CZK 58,528/year vs. CZK 23,082/year). As the estimated number of chronic HF patients is 230,000 (data from the Institute of Health Information and Statistics of the Czech Republic), we can calculate the total cost of all-cause hospitalizations of chronic HF patients to be approximately CZK 7.98 billion per year in the Czech Republic. Conclusion: The data from clinical practice confirm that patients with chronic HF discharged from acute heart failure hospitalization are at high risk of death and/or subsequent hospitalization. The average annual costs for all-cause hospitalizations of CHS patients within the first and second years are CZK 58,528 and CZK 23,082 per patient, respectively. The costs attributed to all-cause hospitalization care of chronic HF patients can be estimated as approximately 7.7% of all annual inpatient expenses of health insurance companies and 2.7% of total healthcare expenditures in the Czech Republic. (C) 2018 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.
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