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Receiving care according to national heart failure guidelines is associated with lower total costs: an observational study in Region Halland, Sweden
Medtigo Medical Group, North Adams, Massachusetts, USA.
Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Halland Regional Hospital, Region Halland, Halmstad, Sweden.
Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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2021 (English)In: European Heart Journal - Quality of Care and Clinical Outcomes, ISSN 2058-5225, E-ISSN 2058-1742, Vol. 7, no 3, p. 280-286Article in journal (Refereed) Published
Abstract [en]

Aims: Patients with heart failure (HF) have high costs, morbidity and mortality, but it is not known if appropriate pharmacotherapy (AP), defined as compliance with international evidence-based guidelines, is associated with improved. The purpose of this study was to evaluate HF patients’ health care utilization, cost and outcomes in Region Halland (RH), Sweden, and if AP was associated with costs.

Methods and Results: 5 987 residents of RH in 2016 carried HF diagnoses. Costs were assigned to all healthcare utilization (inpatient, outpatient, emergency department, primary health care and medications) using a Patient Encounter Costing methodology. Care of HF patients cost €58.6M, (€9 790/patient) representing 8.7% of RH’s total visit expenses and 14.9% of inpatient care expenses. Inpatient care represented 57.2% of this expenditure, totaling €33.5M (€5,601/patient). Receiving AP was associated with significantly lower costs, by €1 130 per patient (p < 0.001, 95% Confidence Interval 574,1 687) Comorbidities such as renal failure, diabetes, COPD and cancer were significantly associated with higher costs.

Conclusion: HF patients are heavy users of healthcare, particularly inpatient care. Receiving AP is associated with lower costs even adjusting for comorbidities, although causality cannot be proven from an observational study. There may be an opportunity to decrease overall costs and improve outcomes by improving prescribing patterns and associated high-quality care. 

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020.

Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2021. Vol. 7, no 3, p. 280-286
Keywords [en]
pharmacotherapy, diabetes mellitus, chronic obstructive airway disease, heart failure, diabetes mellitus, type 2, cancer, kidney failure, comorbidity, emergency service, hospital, inpatients, internship and residency, outpatients, primary health care, guidelines, morbidity, mortality, evidence-based practice, medical residencies, prescribing behavior, health care use, heart failure guidelines
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Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:hh:diva-41792DOI: 10.1093/ehjqcco/qcaa020ISI: 000661521300009PubMedID: 32170930Scopus ID: 2-s2.0-85106069739OAI: oai:DiVA.org:hh-41792DiVA, id: diva2:1415521
Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2021-09-02Bibliographically approved

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Ashfaq, Awais

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