Primary vs. Secondary Heart Failure Diagnosis: Differences in Clinical Outcomes, Healthcare Resource Utilization and Cost

Frontiers in Cardiovascular Medicine

article

Héctor Bueno¹  Clara Goñi¹  Rafael Salguero-Bodes¹  Beatriz Palacios⁶  Lourdes Vicent¹  Guillermo Moreno¹  Nicolás Rosillo⁹  Luis Varela⁶  Margarita Capel⁶  Juan Delgado¹  Fernando Arribas¹  Manuel del Oro⁵  Carmen Ortega⁵  Jose L. Bernal⁵ 

[1] Servicio de Cardiología, Hospital Universitario 12 de Octubre;Spanish National Centre for Cardiovascular Research;Facultad de Medicina, Universidad Complutense de Madrid;Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares;Department of Management Control, Hospital Universitario 12 de Octubre;AstraZeneca;Instituto de Salud Carlos III;Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid;Department of Preventive Medicine, Hospital Universitario 12 de Octubre

关键词: heart failiure;    secondary diagnosis;    outcome;    mortality;    resource utilization;    cost;   

DOI  :  10.3389/fcvm.2022.818525

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background There is scarce information on patients with secondary heart failure diagnosis (sHF). We aimed to compare the characteristics, burden, and outcomes of sHF with those with primary HF diagnosis (pHF). Methods Retrospective, observational study on patients ≥18 years with emergency department (ED) visits during 2018 with pHF and sHF in ED or hospital (ICD-10-CM) diagnostic codes. Baseline characteristics, 30-day and 1-year mortality, readmission and re-ED visit rates, and costs were compared between sHF and pHF. Results Out of the 797 patients discharged home from the ED, 45.5% had sHF, and these presented lower 1-year hospitalization, re-ED visit rates, and costs. In contrast, out of the 2,286 hospitalized patients, 55% had sHF and 45% pHF. Hospitalized sHF patients had significantly ( p < 0.01) greater comorbidity, lower use of recommended HF therapies, longer length of stay (10.8 ± 10.1 vs. 9.7 ± 7.9 days), and higher in-hospital and 1-year mortality (32 vs. 25.8%) with no significant differences in readmission rates and lower 1-year re-ED visit rate. Hospitalized sHF patients had higher total costs (€12,262,422 vs. €9,144,952, p < 0.001), mean cost per patient-year (€9,755 ± 13,395 vs. €8,887 ± 12,059), and average daily cost per patient. Conclusion Hospitalized sHF patients have a worse initial prognosis, greater use of healthcare resources, and higher costs.

【 授权许可】

CC BY