OBJECTIVES: Hospitalization is the key driver of medical costs in heart failure patients. We aimed to calculate the hospitalization costs of heart failure patients.

METHODS: We used the Korean Acute Heart Failure (KorAHF) registry to extract the information on clinical characteristics and medical costs including out-of-pocket expenses. We included the hospitalized patients who had a record of left ventricular ejection fraction (LVEF), which is a clinically important criterion to define the patients as heart failure reduced ejection fraction (HFrEF) or heart failure preserved ejection fraction (HFpEF). Patients with LVEF ≤ 40% were classified as HFrEF group, whereas those with LVEF > 40% were defined as HFpEF group. We calculated the hospitalization costs for each HFrEF and HFpEF group, then examined the cost of subgroups according to in-hospital mortality within each group. The difference in average hospitalization costs between the two groups was determined using the t-test using IBM SPSS Statistics for Windows, version 26.

RESULTS: As a result of analyzing hospitalization data for 5,414 patients, the average hospitalization cost was 10,647,690 KRW, and the median was 4,109,180 KRW. We found that HFrEF patients (n=3,280) paid higher hospitalization costs than HFpEF patients (n=2,134) (average 11,539,638 KRW vs. 9,286,559 KRW [p-value 0.001]; median 4,280,902 vs. 3,800,718). Hospitalization costs were significantly different according to in-hospital mortality in both HFrEF and HFpEF groups. In the HFrEF group, the average hospitalization cost of patients who deceased during hospitalization was 31,754,463 won, whereas that of patients who lived after hospitalization was 10,422,824 KRW (p-value 0.001; median 18,109,770 vs. 4,089,228). The increased hospitalization costs due to in-hospital mortality was higher in the HFpEF group (average 37,094,501 KRW vs. 8,430,040; median 17,551,749 vs. 3,683,643 KRW) than in the HFrEF group.

CONCLUSIONS: The hospitalization cost of heart failure patients is significantly influenced by LVEF and in-hospital mortality.