Heart failurePredicting Costs Among Medicare Beneficiaries With Heart Failure
Section snippets
Methods
We linked Medicare inpatient claims data from January 1, 2003, through December 31, 2006, with data from the OPTIMIZE-HF and GWTG-HF registries (http://www.Clinicaltrials.gov, trial identifier NCT00344513). In 2005 OPTIMIZE-HF transitioned to GWTG-HF under sponsorship of the American Heart Association. The registries had the same design, inclusion criteria, and data-collection methods.5, 6 Outcome Sciences, Inc. (Cambridge, Massachusetts), serves as the data-collection and coordination center
Results
After linking hospitalizations from OPTIMIZE-HF and GWTG-HF to Medicare inpatient claims and applying the exclusion criteria, the study population included 40,317 index cases (Table 1). Ischemic heart disease, diabetes, and hypertension were the most common comorbid conditions. The 75% derivation cohort and the 25% validation cohort were comparable to the full cohort in patient characteristics (data not shown).
As presented in Table 2, unadjusted 1-year mortality was 34.4% and 1-year readmission
Discussion
We used clinical registry data to derive and validate a method for prospectively identifying patients with heart failure who are most likely to incur high costs in the year after a heart failure hospitalization. Although prospective identification of these patients is challenging, it is possible to create a model with adequate discrimination and calibration using data readily available from an inpatient episode of heart failure.
The approach taken to allow prospective identification of patients
Acknowledgment
Damon M. Seils, MA, Duke University, provided editorial assistance and prepared the report. Mr. Seils did not receive compensation for his assistance apart from his employment at the institution where the study was conducted.
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2022, Surgery (United States)Trends in health care expenditure among US adults with heart failure: The Medical Expenditure Panel Survey 2002-2011
2017, American Heart JournalCitation Excerpt :We assembled data on inpatient, outpatient, and ED visits, and prescription medication use. This differs from previous studies on HF costs that have either focused on shorter periods (a few years3,32 or the last few months of life4), on inpatient care/hospital costs only,5-8,30 or have mainly predated the widespread use of novel devices such as cardiac resynchronization and defibrillator9 or left ventricular assist device,10 as well as heart transplant, which have costs that can potentially outweigh all the other HF costs. Of note, some aspects of the other studies that used the MSEP data differed significantly from ours.
Dichotomous Relationship Between Age and 30-Day Death or Rehospitalization in Heart Failure Patients Admitted With Acute Decompensated Heart Failure: Results From the ASCEND-HF Trial
2016, Journal of Cardiac FailureCitation Excerpt :The higher risk of hospitalization for any cause and noncardiovascular hospitalization 30 days after discharge in older patients identified in this analysis is likely a reflection of the increased comorbidities within this age group. The increase in comorbidities seen with increasing age differed in some respects from analyses focusing on Medicare beneficiaries.8 These differences may be due in part to the ASCEND-HF exclusion criteria, which included persistent uncontrolled hypertension and severe pulmonary disease.
Factors associated with variations in hospital expenditures for acute heart failure in the United States
2015, American Heart JournalCitation Excerpt :There are limited studies examining the use of blood transfusions in both stable and decompensated AHF, with insufficient evidence to direct recommendations.13 A prior study measuring annual cost variations among Medicare patients with HF found that comorbidities were associated with increased medical costs.14 Variations in AHF hospitalization expenditures were noted in an analysis with 1997 NIS data where comorbidities and hospital characteristics were also correlated with higher expenditures.15
Effect of zofenopril and ramipril on cardiovascular mortality in patients with chronic heart failure
2013, American Journal of CardiologyCitation Excerpt :The subgroup analysis, however, showed that zofenopril, compared with ramipril, was associated with a relative risk of cardiovascular mortality of −44% in elderly patients, −43% in men and −48% in patients with a low ejection fraction. These subcategories of patients were those, a priori, with a greater probability of readmittance to the hospital because of HF,5 and those with greater costs for their management.6,7 These data are partially in agreement with those from the recently published Survival of Myocardial Infarction Long-Term Evaluation–4 (SMILE-4), in which 771 patients with clinical signs of HF or a left ventricular ejection <45% after acute myocardial infarction were randomized to treatment with zofenopril 60 mg/day or ramipril 10 mg/day for 1 year.
Prediction of Hospitalization Cost and Length of Stay for Patients with Heart Failure Using Deep Learning
2022, LifeTech 2022 - 2022 IEEE 4th Global Conference on Life Sciences and Technologies
Get With the Guidelines-Heart Failure (GWTG-HF) is a program of the American Heart Association, Dallas, Texas, and is supported by Medtronic, Minneapolis, Minnesota; Ortho-McNeil, Raritan, New Jersey; and the American Heart Association Pharmaceutical Roundtable. GWTG-HF has been funded previously by support from GlaxoSmithKline, Brentford, Middlesex, United Kingdom. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) was funded by GlaxoSmithKline. This study was supported by Grant 087512N from the American Heart Association Pharmaceutical Roundtable Outcomes Center, Grant U18HS10548 from the Agency for Healthcare Research and Quality, Rockville, Maryland, Grant R01AG026038 from the National Institute on Aging, Bethesda, Maryland, and grant U01HL066461 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. Dr. Hernandez received Grant 0675060N from the American Heart Association Pharmaceutical Roundtable. Dr. Fonarow is supported by the Ahmanson Foundation, Beverly Hills, California, and the Corday Family Foundation, Beverly Hills, California.