OBJECTIVES: Acute heart failure (AHF) is amongst the most common causes of hospitalisation in the U.S. with direct costs  estimated to be $20.9 billion in 2010. Reducing the duration of hospitalisation for such conditions can have a significant impact on resource use and may also have substantial benefit for individual patients.The aim of this study was to estimate quality of life (utilities) for patients hospitalised with AHF, expressed as a utility score between 0 [dead] and 1.0 [full health] . These data could be used to support an analysis of the cost effectiveness of an intervention in AHF. METHODS: Proxy assessments of HRQL were collected from 50 experienced cardiac nurses (formal caregivers) and 50 family caregivers of individuals who had experienced AHF events leading to hospitalisation (informal caregivers). Data were collected retrospectively for four time points (day 1, 3, 5 and 7 post cardiac event) using the EQ-5D health status instrument. RESULTS: The results suggest that HRQoL is poor for hospitalised patients but quickly improves over time in response to treatment. Formal caregivers reported HRQoL to be substantially poorer for individuals immediately after admission to hospital when compared to informal caregivers. By day 7 however, formal caregivers rated patients’ HRQoL as being better when compared to informal caregivers’ assessments. CONCLUSIONS: Collection of utility data in severe acute conditions is challenging. This study represents an attempt to capture such values through the use of proxy assessment. The data suggest that hospitalization due to AHF is associated with very poor HRQoL, at least in the short term. Utility values for early assessments approximate those for conditions such as advanced cancers or major stroke. By day 7 however these values demonstrate significant improvement and a return to near normal general population levels.