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Treatment costs of heart failure tenfold in exacerbation - Sydämen vajaatoiminnan hoitokustannukset

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New study: Treatment costs of heart failure increase tenfold in exacerbation

The result of our recent original article surprised the researchers: the costs of managing patients with heart failure increase tenfold in exacerbation compared to prior time. The results were published in the Finnish medical science journal Duodecim on 23rd March 2023.

The costs of heart failure increase in Finland, although its prevalence declines. This is due to the increase in patient numbers. Each exacerbation of heart failure increases the costs of management. The costs of managing exacerbation accumulate mostly from specialized healthcare facilities.

The published study provides new information healthcare resource use and its costs in different phases of the disease. In addition, it describes regional prevalence in Finland. Data for this study was aggregated from the Care register for healthcare of the Finnish Institute for health and welfare. Each included patient had received at least two heart failure diagnoses during 2012-2019. These patients totaled 115,470.

Especially elderly people suffer from heart failure. Mortality is high. It is also one of the most common reasons for hospital admission.

Clinicians can assess the need for resources more specifically

Docent and Specialist in Internal Medicine and Cardiology, Markku Pentikäinen from HYKS Heart and Lung Center and the University of Helsinki states that information on the costs of treatment was an especially interesting finding.

According to the study, each exacerbation increased the costs of treatment. In exacerbation (hospital admission period and costs in the following month), the costs were almost tenfold compared to the prior time.

“So far, there has only been estimates of the number of patients and how much treatment costs. Now we have data. We have access to actual numbers regarding the amount of patients and their age in Finland. We can assess how resources are utilized in treatment”

Medaffcon’s Data Analysis Lead Iiro Toppila considers the information of exacerbation’s impact on costs most astounding. “First, we wondered if this could be right, and thus we reviewed the results. It turned out that the results were correct: costs tenfold at exacerbation”, tells Toppila.

Authorities can compare the costs of medicinal care and hospital care

Pentikäinen states that the study also helps the authorities. They can estimate what the cost of medicinal care is compared to hospital admission.

Medicinal care improves the prognosis of heart failure and reduces the need for hospitalisation. On the basis of this study, the use of medicinal care could be improved. Health technology developed to support self-care could also be helpful.

According to Pentikäinen, the average treatment periods of the patients were surprisingly long. The share of in-patient days in treatment was remarkable: in the first exacerbation, an average of 17 days and in the following exacerbation, 21 in-patient days on average.

“In our unit, most patients are discharged in little less than a week, which means that the treatment periods in other hospitals are much longer”, says Pentikäinen.

In our study, an in-patient period was considered as an exacerbation leading to a more serious phase of the disease. Approximately half of the patients suffered at least one exacerbation, mostly treated in specialized healthcare facilities. Exacerbations rarely appear unexpectedly; thus, preventing them could be possible. Preventing exacerbation would also decrease the costs of patient management.

Researchers from Medaffcon, Bayer, Hyks and Tyks

The study was initiated by the pharmaceutical company Bayer. The article based on an aggregate data request, from which the research group obtained the data in late 2020. Medaffcon prepared the research questions.

“Plenty of data is available from the Finnish registries. One must know what to look for in order to receive an answer to the right questions”, says Sr. Scientific Advisor Liisa Ukkola-Vuoti.

According to Toppila, a single aggregate data request yielded tremendous results. The researcher is also intrigued to continue the study.

The study was carried out by Sr. Scientific Advisor Liisa Ukkola-Vuoti and Data Analysis Lead Iiro Toppila from Medaffcon, Health Economics & Outcome Research Manager Niina Säävuori and Senior Medical Advisor Anna Kirjavainen from pharmaceutical company Bayer, Chief Physician Heikki Ukkonen from Turku University Hospital and Chief Physician Markku Pentikäinen from HYKS Cardiology and Lung Center. The aggregate data was produced by THL analyst Visa Martikainen.

“Cooperation in this project was smooth and the process went nicely”, praises Pentikäinen.

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