ANALYSIS OF FACTORS ASSOCIATED WITH HEALTH CARE COSTS FOR PATIENTS WITH HEART FAILURE IN THAILAND- A REGRESSION-BASED APPROACH
Author(s)
Yingchoncharoen T1, Numuang K2, Kim H3
1Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 2Novartis (Thailand) Limited, Bangkok, Thailand, 3Novartis Korea Limited, Seoul, Korea, Republic of (South)
OBJECTIVES: Heart failure (HF) imposes a substantial economic burden on patients and the health care system. This study aimed to estimate the direct medical costs of patients with HF in Thailand and to identify factors associated with these costs. METHODS: A retrospective cohort study was conducted using the medical records of adult patients with confirmed HF who visited a medical school due to HF between January 1 and December 31, 2014. Multivariate regression analysis was performed to investigate the associations between independent variables and the annual HF-related costs. Generalized linear models (GLMs) with a log-link function and a gamma distribution were used to estimate the cost function. Independent variables included demographic and clinical characteristics, comorbidities, and health care resource utilization. All statistical inferences were based on nonparametric bootstrap confidence intervals. RESULTS: A total of 100 HF patients (mean age of 69.7+13.3 years) were included, with 54.0% females. Approximately 49.0% of total patients were hospitalized during the 1-year follow-up period, and 18.4% of those were readmitted for HF. The average annual cost incurred by patients with hospitalization was much higher than those with outpatient visit only (USD 7,181 vs. USD 381 per patient). The GLM analysis showed that LVEF < 40% was a positive predictor of the increasing HF-related costs (95%CI: 0.076 to 2.034), whereas NYHA I and NYHA II were associated with the lower HF-related costs in comparison with NYHA IV (95%CI: -5.475 to -3.576 and -2.266 to -0.429, respectively). CONCLUSIONS: The financial burden of HF has continued to increase, and hospitalization is a major cost driver. Country-wide efforts to decrease hospitalization should be intensified to reduce overall HF-related costs. Focusing on high-cost patients may possibly reduce health care costs. The findings of this study can be used to improve HF management and inform health service planning.
Conference/Value in Health Info
2018-09, ISPOR Asia Pacific 2018, Tokyo, Japan
Value in Health, Vol. 21, S2 (September 2018)
Code
PCV28
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders