Heart Failure Related Costs And Health Care Resource Utilization Following An Emergency Department (Ed) Visit For Worsening Heart Failure: A Claims Data Analysis

Introduction Heart failure (HF) affects nearly 6.5 million people in the US and it is the leading cause of hospitalizations in adults \u003e65 with costs accounting for 17% of overall national health expenditures. We conducted an analysis to evaluate the HF-related cost and healthcare resource utilization (HCRU) associated with worsening HF (WHF) in patients presenting to an ED and 1.) Managed as an outpatient or 2.) Hospitalized for 1-3 days. Methods Patients (≥18) with a hospitalized/outpatient WHF ED episode were identified using IBM® MarketScan® Commercial and Medicare Supplemental Databases (2012-2017). For the hospitalized cohort, WHF was defined as an inpatient claim with a primary diagnosis of HF and HF/HF-related DRG codes, with ED service category and length of stay (LOS) 1-3 days. For the outpatient cohort, WHF was defined as an outpatient claim with the presence of a primary diagnosis of HF, along with a procedure code for IV furosemide with an ED service category. Patients continuously enrolled 6 months before and 3 months post the index date (first WHF episode) were followed until 30 days. 30-day HF-related medical costs (including index and through day 30) and HCRU were measured. All costs included were unadjusted gross, including payer and patient costs and inflated to $2019 using the Medical Care Consumer Price Index. Results 41,522 and 11,585 patients with WHF were identified in the hospitalized and outpatient cohorts, respectively. Comorbidities were similar between cohorts. Frequent conditions included COPD, diabetes, renal disease, peripheral vascular disease and cerebrovascular disease. Most of the hospitalized cohort (60.5%) had a LOS of 1-2 days. Unadjusted mean 30-day HF-related total medical costs (Table 1) were $14,469.83 (hospitalized) and $5,593.15 (outpatient). In the outpatient cohort, 16.1% of patients had at least one more consecutive WHF visit following the index visit. In this population, 30-day hospitalization rates were 3.3% and 6.7% for the hospitalized and outpatient cohorts, respectively. Conclusion WHF presenting to the ED and requiring a 1-3 day inpatient admission or outpatient management is associated with extensive healthcare costs and resource utilization. These findings highlight the importance of developing new home-based treatments for WHF that could result in potential cost savings to the healthcare system.