PMID- 22510016
OWN - NLM
STAT- MEDLINE
DCOM- 20130114
LR  - 20181201
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 15
IP  - 5
DP  - 2012
TI  - Resource utilization and cost of heart failure associated with reduced ejection 
      fraction in Swedish patients.
PG  - 938-46
LID - 10.3111/13696998.2012.686464 [doi]
AB  - AIM: The purpose of this study was to assess healthcare utilization and costs for 
      heart failure patients with reduced ejection fraction (HF-REF) in Sweden. METHODS 
      AND RESULTS: This was a retrospective, population-based cohort study of patients 
      diagnosed with HF-REF during a period of 18 months at 31 primary care centers in 
      Uppsala County, Sweden. Data was obtained from computerized records from these 
      centers, the Swedish Patient Registry, the Swedish Prescription Registry, the 
      Cause of Death Registry, and a local echocardiography registry maintained by the 
      Department of Physiology, Uppsala University Hospital. Main outcome measures were 
      cardiovascular and heart-failure-related hospitalizations, outpatient visits, 
      medication utilization, mortality (all-cause, cardiovascular, and heart-failure), 
      and healthcare costs for HF-REF patients. During the index period, 252 heart 
      failure patients had a left ventricular ejection fraction measurement </= 40% and 
      were categorized as having HF-REF. More than half of the patients had >/= 1 
      cardiovascular or heart failure-related hospitalization. On average, patients had 
      >2 such hospitalizations annually. They also averaged  approximately 1 cardiovascular or 
      heart-failure-related outpatient visit per year. All-cause mortality was high: 
      15.9% patients died within 1 year after the index date. The mean annual cost per 
      patient for heart-failure-related hospitalizations was SEK 72,613 (EUR 7610). In 
      contrast, annual prescription costs were low, on average 3% of total cost (SEK 
      3503, EUR 367 per patient) LIMITATIONS: The main limitations of this study 
      include a short follow-up time and small sample size. Also, certain data were 
      missing, such as echocardiograms (available for only 28% of patients), and 
      information on patients' New York Heart Association (NYHA) functional class, 
      validity period for prescriptions or the units of medication prescribed, and 
      medication dosing. Furthermore, the overall mortality could have been 
      under-estimated, as only the primary cause of death was included in the analysis. 
      CONCLUSIONS: The main burden associated with HF-REF is related to 
      hospitalizations for heart-failure events. Effective treatment options that 
      decrease hospitalization rates could reduce patients' suffering and potentially 
      offer considerable cost savings.
FAU - Stalhammar, Jan
AU  - Stalhammar J
AD  - Department of Public Health and Caring Sciences, Uppsala University, Uppsala, 
      Sweden.
FAU - Stern, Lee
AU  - Stern L
FAU - Linder, Ragnar
AU  - Linder R
FAU - Sherman, Steven
AU  - Sherman S
FAU - Parikh, Rohan
AU  - Parikh R
FAU - Ariely, Rinat
AU  - Ariely R
FAU - Wikstrom, Gerhard
AU  - Wikstrom G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120517
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Drug Therapy
MH  - Female
MH  - Health Resources/*economics/*statistics & numerical data
MH  - Heart Failure/*economics/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Stroke Volume/*physiology
MH  - Sweden
EDAT- 2012/04/19 06:00
MHDA- 2013/01/15 06:00
CRDT- 2012/04/19 06:00
PHST- 2012/04/19 06:00 [entrez]
PHST- 2012/04/19 06:00 [pubmed]
PHST- 2013/01/15 06:00 [medline]
AID - 10.3111/13696998.2012.686464 [doi]
PST - ppublish
SO  - J Med Econ. 2012;15(5):938-46. doi: 10.3111/13696998.2012.686464. Epub 2012 May 
      17.