OBJECTIVES: Heart failure with preserved ejection fraction (HFpEF) presents an increasing healthcare challenge in the ageing United States (US) population. To explore the related economic disease burden, we assessed trends in the rates of hospital discharges and related costs in patients with HFpEF in the US between 2009 and 2016.

METHODS: Patients hospitalised with a principal diagnosis of HFpEF were identified in the Healthcare Cost and Utilization Project database (HCUP). Eligible ICD codes included I50.30-33 (ICD-10) and 428.30-33 (ICD-9). We collected data on hospital discharges, costs and aggregate charges (the ‘national bill’); these were adjusted to 2016 US dollars using inflation rates. Descriptive statistics were used for data analysis.

RESULTS: Among patients with HFpEF between 2009 and 2016, there was a 13% increase in the rate of discharges (from 81 to 92 per 100,000 people), as well as increases in hospital charges (by 33%) and total charges (by 102%). Consequently, by 2016, expenditure was highest for mean hospital costs (hospital expenses) of $10,504/discharge and mean hospital charges (amount billed to hospital for an entire hospital stay) of $41,940/discharge. The aggregate hospital costs were $3,117,785,774, while aggregate hospital charges (the national bill) were $12,450,486,162. Major contributors to the national bill included Medicare beneficiaries (78%), women (61%), and residents in the following US Census divisions: South (37%), South Atlantic (20%), Middle Atlantic (19%) and Pacific (16%). The national bill was mostly accounted for by hospitalisations with a principal diagnosis of either exacerbation of congestive HFpEF ($10,049,225,223; 81%) or with acute HFpEF ($1,970,145,875; 16%).

CONCLUSIONS: The continuing increase in the economic burden due to HFpEF is in line with the ageing of the general population and the inadequacies of available treatment options. Development of life-saving and cost-effective treatments is urgently required to alleviate patient suffering and reduce the societal costs of the condition.