OBJECTIVES

: Analysis of healthcare expenditure of patients with heart failure for 12 months from the time of index admission.

METHODS

: Manipal Heart Failure Registry (MHFR), established in 2015 in a tertiary care hospital in Southern India, is a prospective observational cohort of patients diagnosed with heart failure. From this registry, we analysed the total expense incurred during index hospitalization from in-patient bills which included the consultation charges, expenses for ICU/ward stay, investigations, interventional procedures and medications. Similarly, the expenses incurred for medications, visits and re-hospitalization(s) during the 12 month follow up period were calculated.

RESULTS

: A total of 610 patients with mean age of 65.0 ± 13.6 years were included among which 59.8% were males and 38.9% had ischemic heart failure. Average duration of index hospitalization was 5.3 days with an average expenditure of INR 59492 (€710). This included the charges for hospitalization and consumables [INR 9210.9 (€110)], investigations [INR 6465.0 (€65)], medicines, devices and procedural charges [INR 38940.1 (€461)], consultation/professional charges [INR 2158.2 (€26)] and expenditure incurred by caregivers [INR 2717.8 (€40)]. Follow up data was available for 98.1% of the patients. Re-hospitalization rate was 10.8% and 34.1% patients had unscheduled visits to the hospital due to worsening symptoms. Average expenses during the 12 months follow-up period was INR 22680 (€268) which included re-hospitalizations, scheduled/unscheduled visits, and medications. Patients who were non-compliant to medicines or were re-hospitalized during the follow up period spent considerably more than those who were not [INR 32876 (€387) vs INR 20899 (€247), p= 0.042; INR 35255 (€416) vs INR 20213 (€237), p= 0.002, respectively].

CONCLUSIONS

: Healthcare expenditure of patients with heart failure in India is much lower than their western counterparts. Hospitalizations and interventional procedures account for bulk of the expenses incurred. Drug non-compliance is an important and easily avoidable cause for increased healthcare expenditure.