Acute Care visits and Readmissions Among Commercial Plan Enrollees with Heart Failure with Preserved Ejection Fraction (HFpEF) by Obesity Classes
Author(s)
Navneet Upadhyay, PhD1, Kirti Batra, MBA2, Lisa Le, MS2, Andrea Steffens, MPH2, Maureen H. Carlyle, MPH2, Rui Song, PhD2, Thomas Horstman, BS2, Dustin Ruff, PhD3, Arian Plat, PhD3;
1Eli Lilly and Co., Indianapolis, IN, USA, 2Optum, Eden Prairie, MN, USA, 3Eli Lilly and Company, Indianapolis, IN, USA
1Eli Lilly and Co., Indianapolis, IN, USA, 2Optum, Eden Prairie, MN, USA, 3Eli Lilly and Company, Indianapolis, IN, USA
OBJECTIVES: To assess all-cause hospitalization/emergency room [ER] (acute care) visits, rehospitalization rates, and costs across obesity classes among commercial plan enrollees with heart failure with preserved ejection fraction (HFpEF).
METHODS: This retrospective study used administrative claims linked with electronic health records of commercial enrollees in Optum’s Market Clarity Database from 01/01/2015 - 03/31/2023. Adults with HF diagnosis from 01/01/2016-03/31/2022 (index date = 12 months following first HF claim) and evidence of HFpEF (left ventricular ejection fraction≥50%) were categorized according to body mass index (BMI) classes: class 3 obesity (BMI ≥40 kg/m2), class 2 obesity (35-40 kg/m2), class 1 obesity (30-35 kg/m2). Per-patient-per-year (PPPY) acute care visits and costs [2023 USD] were assessed among those with ≥12-month follow-up and 30-day rehospitalization was assessed among all study sample.
RESULTS: Overall, 15,287 HFpEF patients (37.9% class 1 obesity, 25.9% class 2 obesity, 36.2% Class 3 obesity) were identified. Class 3 obesity cohort had numerically lower mean age and higher proportion of female, Black race and those with hypertension, type 2 diabetes, obstructive sleep apnea, osteoarthritis and asthma compared to other obesity cohorts. Among the Class 1, Class 2, and Class 3 obesity cohorts, mean (SD) counts of emergency department visits were 1.0 (2.0), 1.0 (1.9), and 1.4 (2.9) and mean (SD) counts of inpatient days among those hospitalized were 7.5 (15.9), 7.5 (19.1), and 9.3 (17.9), respectively. 30-day rehospitalization rate per 1,000 person-years was 84 for class 1 obesity, 71 for class 2 obesity, and 86 for class 3 obesity cohorts. Patients with class 3 obesity had numerically highest mean (SD) acute care costs ($22,031 [$53,036]) and total (medical + pharmacy) costs ($56,220 [$79,110]).
CONCLUSIONS: High all-cause acute care visits, increased readmissions rates, and higher costs were observed among commercial enrollees with HFpEF and obesity highlighting the economic burden of obesity among HFpEF patients.
METHODS: This retrospective study used administrative claims linked with electronic health records of commercial enrollees in Optum’s Market Clarity Database from 01/01/2015 - 03/31/2023. Adults with HF diagnosis from 01/01/2016-03/31/2022 (index date = 12 months following first HF claim) and evidence of HFpEF (left ventricular ejection fraction≥50%) were categorized according to body mass index (BMI) classes: class 3 obesity (BMI ≥40 kg/m2), class 2 obesity (35-40 kg/m2), class 1 obesity (30-35 kg/m2). Per-patient-per-year (PPPY) acute care visits and costs [2023 USD] were assessed among those with ≥12-month follow-up and 30-day rehospitalization was assessed among all study sample.
RESULTS: Overall, 15,287 HFpEF patients (37.9% class 1 obesity, 25.9% class 2 obesity, 36.2% Class 3 obesity) were identified. Class 3 obesity cohort had numerically lower mean age and higher proportion of female, Black race and those with hypertension, type 2 diabetes, obstructive sleep apnea, osteoarthritis and asthma compared to other obesity cohorts. Among the Class 1, Class 2, and Class 3 obesity cohorts, mean (SD) counts of emergency department visits were 1.0 (2.0), 1.0 (1.9), and 1.4 (2.9) and mean (SD) counts of inpatient days among those hospitalized were 7.5 (15.9), 7.5 (19.1), and 9.3 (17.9), respectively. 30-day rehospitalization rate per 1,000 person-years was 84 for class 1 obesity, 71 for class 2 obesity, and 86 for class 3 obesity cohorts. Patients with class 3 obesity had numerically highest mean (SD) acute care costs ($22,031 [$53,036]) and total (medical + pharmacy) costs ($56,220 [$79,110]).
CONCLUSIONS: High all-cause acute care visits, increased readmissions rates, and higher costs were observed among commercial enrollees with HFpEF and obesity highlighting the economic burden of obesity among HFpEF patients.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE77
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)