| アブストラクト | BACKGROUND: Evidence on the economic impact of heart failure (HF) is vital in order to predict the cost-effectiveness of novel interventions. We estimate the health system costs of HF during the last five years of life. METHODS: We used linked primary care and mortality data accessed through the Clinical Practice Research Datalink (CPRD) to identify 1555 adults in England who died with HF in 2012/13. We used CPRD and linked Hospital Episode Statistics to estimate the cost of medications, primary and hospital healthcare. Using GLS regression we estimated the relationship between costs, HF diagnosis, proximity to death and patient characteristics. RESULTS: In the last 3months of life, healthcare costs were pound8827 (95% CI pound8357 to pound9296) per patient, more than 90% of which were for inpatient or critical care. In the last 3months, patients spent on average 17.8 (95% CI 16.8 to 18.8) days in hospital and had 8.8 (95% CI 8.4 to 9.1) primary care consultations. Most (931/1555; 59.9%) patients were in hospital on the day of death. Mean quarterly healthcare costs in quarters after HF diagnosis were higher ( pound1439; [95% CI pound1260 to pound1619]) than in quarters preceding diagnosis. Older patients and patients with lower comorbidity scores had lower costs. CONCLUSIONS: Healthcare costs increase sharply at the end of life and are dominated by hospital care. There is potential to save money by implementation and evaluation of interventions that are known to reduce hospitalisations for HF, particularly at the end of life. |
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| ジャーナル名 | International journal of cardiology |
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| 投稿日 | 2016/10/25 |
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| 投稿者 | Hollingworth, William; Biswas, Mousumi; Maishman, Rachel L; Dayer, Mark J; McDonagh, Theresa; Purdy, Sarah; Reeves, Barnaby C; Rogers, Chris A; Williams, Rachael; Pufulete, Maria |
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| 組織名 | School of Social and Community Medicine, University of Bristol, Bristol, UK.;Electronic address: William.hollingworth@bristol.ac.uk.;Clinical Trials and Evaluation Unit, School of Clinical Sciences, University of;Bristol, Bristol, UK.;Department of Cardiology, Taunton and Somerset NHS Foundation Trust, Taunton, UK.;King's College Hospital, London, UK.;Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory;Agency, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27648982/ |
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