Resource use and costs in systolic heart failure according to disease severity: a pooled analysis from the German Competence Network Heart Failure

Aim Systolic chronic heart failure (CHF) is currently one of the most prevalent cardiac diseases. The present analysis sought to estimate the 1-year disease-related resource use and associated management costs of patients with CHF. Subject and methods A total of 2,710 individuals with systolic CHF [mean age 62.9 years +/- 13.6, 25.2% female, New York Heart Association (NYHA) I-IV] were included from the German Competence Network Heart Failure. Disease-related resource use was assessed with regard to outpatient contacts with physicians,hospitalizations including rehabilitation stays and drug utilization. Results During 1 year, patients had on average 6.1 contacts with their general practitioner, 1.7 contacts with cardiologists and 0.8 hospital stays per year. Overall disease-related health care costs per patient were calculated at 3,150 epsilon per year. The largest component related to hospitalizations (2,328 epsilon, 74%), while costs of rehabilitation (294 epsilon, 9%), medication (290 epsilon, 9%) and outpatient contacts (238 epsilon, 8%) were considerably lower. Compared with 2,474 epsilon in NYHA class I, there was a cost increase in NYHA II, III and IV of 14, 48 and 71%, respectively. About 76% of this cost increase resulted from augmented hospital (inpatient) resource use. Conclusion The present analysis demonstrates a high disease-related resource consumption of heart failure care. In particular, patients in higher NYHA classes require increased inpatient resources. Hence, improved treatment strategies need to be developed to optimize care thus reducing hospitalization rates.