Cor Vasa 2013, 55(1):e7-e14 | DOI: 10.1016/j.crvasa.2012.10.004

Cardiology department hospitalization costs in patients with acute heart failure vary according to the etiology of the acute heart failure: Data from the AHEAD Core registry 2005-2009

Barbora Říhová^a, Jiří Pařenica^b,c,d,*, Jiří Jarkovský^e, Roman Miklík^a,d, Alexandra Šulcová^a,f, Simona Littnerová^e, Marián Felšöci^b, Petr Kala^b,c, Jindřich Špinar^b,c,d

^a Farmakologický ústav, Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

^b Interní kardiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice Brno, Brno, Česká republika

^c Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

^d International Clinical Research Center - I. interní kardioangiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny, Brno, Česká republika

^e Institut biostatistiky a analýz, Masarykova univerzita, Brno, Česká republika

^f CEITEC - Central European Institute of Technology, Masarykova univerzita, Brno, Česká republika

Background: To assess the distribution of costs associated with Cardiology Unit hospitalization due to acute heart failure (AHF) and evaluate, from the perspective of the healthcare payer, the heterogeneity of resources use according to AHF etiology in patients from 2005 to 2009.

Methods: The type and etiology of AHF was determined upon hospital admission. The cost of in-patient care was based on the individual hospital account of each patient (1759 patients in total; 58.7% male; mean age 71 years).

Results: The median hospital stay was 7 days and the mean total cost of in-patient care was €3364. A Coronary Care Unit (CCU) stay was recorded in 67.4% patients (median 3 days). Significantly higher costs were found in de-novo AHF patients (mean €3678) with a greater need for CCU care, a longer stay in the CCU and a greater need for intervention (particularly that of percutaneous coronary intervention [PCI]), than in patients with acute decompensation of chronic heart failure (mean cost €2878; p < 0.001). Acute coronary syndrome was a major precipitating factor, with the highest costs (€4429) resulting from having received PCI (63.3% of patients) and CCU admission (91.7% of patients). Variations in length of stay according to AHF etiology were minor (median, 6-8 days). In-hospital mortality was 15.0%.

Conclusions: Hospitalization costs as they relate to AHF are high, particularly in new-onset AHF patients. The heterogeneity of resources use is largely a reflection of interventions undertaken, particularly if revascularization or anti-arrhythmic therapy is provided.

Keywords: AHEAD registry; Heart failure; In-hospital costs

Received: June 24, 2012; Revised: October 21, 2012; Accepted: October 22, 2012; Published: February 1, 2013  Show citation