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Costs and healthcare utilisation of patients with heart failure in Spain

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Background: Increasing the knowledge about heart failure (HF) costs and their determinants is important to
ascertain how HF management can be optimized, leading to a significant decrease of HF costs. This study
evaluated the cumulative costs and healthcare utilisation in HF patients in Spain.
Methods: Observational, retrospective, population-based study using BIG-PAC database, which included data from
specialized and primary care of people ≥18 years, from seven autonomous communities in Spain, who received
care for HF between 2015 and 2019. The healthcare and medication costs were summarized on a yearly basis
starting from the index date (1st January 2015), and then cumulatively until 2019.
Results: We identified 17,163 patients with HF (year 2015: mean age 77.3 ± 11.8 years, 53.5% men, 51.7% systolic HF,
43.6% on NYHA functional class II). During the 2015–2019 period, total HF associated costs reached 15,373 Euros
per person, being cardiovascular disease hospitalizations the most important determinant (75.8%), particularly HF
hospitalizations (51.0%). Total medication cost accounted for 7.0% of the total cost. During this period, there was a
progressive decrease of cardiovascular disease hospital costs per year (from 2834 Euros in 2015 to 2146 Euros in
2019, P < 0.001), as well as cardiovascular and diabetic medication costs.
Conclusions: During the 2015–2019 period, costs of HF patients in Spain were substantial, being HF
hospitalizations the most important determinant. Medication costs represented only a small proportion of total
costs. Improving HF management, particularly through the use of drugs that reduce HF hospitalization may be
helpful to reduce HF burden.

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BMC Health Services Research, 2020, vol. 20

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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Costs and healthcare utilisation of patients with heart failure in Spain