Acute Care Visits and Readmissions Among Medicare Beneficiaries 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. Carlyle2, Rui Song, PhD2, Thomas Horstman, MS2, Dustin Ruff, PhD1, Arian Plat, PhD1;
1Eli Lilly, Indianapolis, IN, USA, 2Optum, Eden Prairie, MN, USA
OBJECTIVES: To assess all-cause hospitalization/emergency room (ER) [acute care] visits, rehospitalization rates, and costs across obesity classes among Medicare beneficiaries with heart failure with preserved ejection fraction (HFpEF) and obesity.
METHODS: This retrospective database study used administrative claims linked with electronic health records for Medicare members 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 into the cohorts according to body mass index (BMI) class: class 3 obesity (BMI ≥40 kg/m2), class 2 obesity (35-40 kg/m2), and class 1 obesity (30-35 kg/m2). Per-patient-per-year (PPPY) acute care visits and costs [2023 USD] and 30-day readmission rates were assessed during variable ≥12-month follow-up.
RESULTS: Overall, 24,314 HFpEF patients (43.0% class 1 obesity, 27.8% class 2 obesity, 29.2% class 3 obesity) were identified. HFpEF patients with class 3 obesity had numerically lower mean age; had higher proportion of females; Black race; and those with 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 ER visits were 1.8 (3.7), 1.9 (4.1) and 2.3 (4.7) and mean (SD) counts of inpatient days were 15.5 (32.6), 15.8 (30.5) and 21.0 (39.8) in ≥12-month follow-up, respectively. The rate of 30-day rehospitalization per 1,000 person-years was 126 for class 1, 125 for class 2, and 145 for class 3 obesity cohorts. Patients with class 3 obesity had numerically highest mean (SD) acute care costs ($42,086 [$75,150]) and total (medical + pharmacy) costs ($84,543 [$101,891]).
CONCLUSIONS: HFpEF patients with obesity experienced high levels of all-cause acute care visits, readmissions rates, and costs, highlighting the burden of obesity among population with HFpEF.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

EE498

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)

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