Early Outpatient Follow-Up and Reduced Health Care Resource Utilization in Acute Heart Failure in Germany: A Descriptive Analysis
Author(s)
Anna Stürmlinger, MSc1, Marie Zalesiak, MASc2, Djawid Hashemi, PD Dr. med.3, Roman Stehle, M.Sc.1, Sima Melnik, Dipl.4, Jennifer Riedel, Dr.4.
1Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany, 2Boehringer Ingelheim, Ingelheim, Germany, 3Charité - Universitätsmedizin Berlin, Berlin, Germany, 4Gesundheitsforen Leipzig GmbH, Leipzig, Germany.
1Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany, 2Boehringer Ingelheim, Ingelheim, Germany, 3Charité - Universitätsmedizin Berlin, Berlin, Germany, 4Gesundheitsforen Leipzig GmbH, Leipzig, Germany.
OBJECTIVES: This descriptive study aimed to characterize healthcare resource utilization and work-related functional impact in patients hospitalized for acute heart failure (AHF), stratified by early (0 - 7 days) versus late (>7 days) outpatient follow-up within 90 days post-discharge.
METHODS: This retrospective real-world evidence study analyzed data from the German Analysis Database for years 2014-2022. The cohort included adults with a primary diagnosis of AHF (identified via ICD-10-GM codes I50, I11.0, I13.0, I13.2, or I42), or secondary AHF diagnoses during hospitalizations in cardiology, internal medicine, or emergency care. Primary diagnosed myocardial infarction (I21) patients receiving mechanical circulatory support were also included. The index hospitalization was the first AHF admission after a 365-day AHF-free inpatient period, excluding patients who died during the index or following year. Outcomes observed within 365 days post-discharge included AHF-related rehospitalization, incapacity to work (≤65 years, not deceased), and sickness benefit claims (≤65 years, not deceased, entitled).
RESULTS: Among the 81,206 patients, 28% (n=22,460) experienced AHF-related rehospitalization (mean 1.5 per patient, median length: 7 days), of which 97% (n = 22,168) had outpatient follow-up. In patients with at least one AHF-related incapacity to work event, the median duration was 108 days in the early follow-up group compared to 117 days in the late follow-up group. The median sickness benefit amount for eligible patients with at least one sickness benefit event was €8,330 (early group) and €9,670 (late group) (median difference: €1,300). This difference should be interpreted cautiously, as the analysis did not control for potential confounders. Similar trends were observed in all-cause sickness benefit claims, with maximum costs reaching €51,018 in the late follow-up group.
CONCLUSIONS: These findings highlight the substantial burden of AHF and reveal observed differences in reported outcomes between early and late outpatient follow-up groups. Timely follow-up may help reduce healthcare and work-related burden, warranting further investigation.
METHODS: This retrospective real-world evidence study analyzed data from the German Analysis Database for years 2014-2022. The cohort included adults with a primary diagnosis of AHF (identified via ICD-10-GM codes I50, I11.0, I13.0, I13.2, or I42), or secondary AHF diagnoses during hospitalizations in cardiology, internal medicine, or emergency care. Primary diagnosed myocardial infarction (I21) patients receiving mechanical circulatory support were also included. The index hospitalization was the first AHF admission after a 365-day AHF-free inpatient period, excluding patients who died during the index or following year. Outcomes observed within 365 days post-discharge included AHF-related rehospitalization, incapacity to work (≤65 years, not deceased), and sickness benefit claims (≤65 years, not deceased, entitled).
RESULTS: Among the 81,206 patients, 28% (n=22,460) experienced AHF-related rehospitalization (mean 1.5 per patient, median length: 7 days), of which 97% (n = 22,168) had outpatient follow-up. In patients with at least one AHF-related incapacity to work event, the median duration was 108 days in the early follow-up group compared to 117 days in the late follow-up group. The median sickness benefit amount for eligible patients with at least one sickness benefit event was €8,330 (early group) and €9,670 (late group) (median difference: €1,300). This difference should be interpreted cautiously, as the analysis did not control for potential confounders. Similar trends were observed in all-cause sickness benefit claims, with maximum costs reaching €51,018 in the late follow-up group.
CONCLUSIONS: These findings highlight the substantial burden of AHF and reveal observed differences in reported outcomes between early and late outpatient follow-up groups. Timely follow-up may help reduce healthcare and work-related burden, warranting further investigation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE53
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)