Table 2.
Unadjusted HCRU and costs during the worsening and post-worsening assessment periods
| Worsening assessment period | Post-worsening assessment period | |||||
|---|---|---|---|---|---|---|
| Patients with stable chronic HFrEF (N = 12,186) | Patients with chronic HFrEF following a worsening HF event (N = 4460) | P value | Patients with stable chronic HFrEF (N = 12,186) | Patients with chronic HFrEF following a worsening HF event (N = 4460) | P value | |
| Duration of study period, mean (SD) days | –a | –a | 329 (86) | 310 (103) | – | |
| HF-related HCRU, mean (SD) PPPM | ||||||
| Hospitalizations | –b | –b | –b | 0.02 (0.01) | 0.08 (0.03) | < 0.0001 |
| Length of hospital stay | –b | –b | –b | 0.15 (0.07) | 0.68 (0.27) | < 0.0001 |
| Outpatient visits | 1.33 (0.36) | 1.65 (0.50) | < 0.0001 | 1.23 (0.32) | 1.46 (0.41) | < 0.0001 |
| ED visits | 0.008 (0.002) | 0.093 (0.041) | < 0.0001 | 0.02 (0.01) | 0.07 (0.02) | < 0.0001 |
| All-cause HCRU, mean (SD) PPPM | ||||||
| Hospitalizations | 0.02 (0.01) | 0.16 (0.01) | < 0.0001 | 0.04 (0.02) | 0.13 (0.05) | < 0.0001 |
| Length of hospital stay, days | 0.28 (0.10) | 1.43 (0.06) | < 0.0001 | 0.27 (0.13) | 1.00 (0.42) | < 0.0001 |
| Outpatient visits | 2.77 (1.26) | 3.89 (1.77) | < 0.0001 | 2.51 (1.27) | 3.31 (1.91) | < 0.0001 |
| ED visits | 0.06 (0.02) | 0.24 (0.01) | < 0.0001 | 0.07 (0.02) | 0.20 (0.07) | < 0.0001 |
| HF-related costs, mean (SD) $ PPPM | ||||||
| Total | 363 (596) | 3446 (5658) | < 0.0001 | 595 (1215) | 1946 (3984) | < 0.0001 |
| Hospitalization | –b | –b | –b | 441 (170) | 1585 (444) | 0.0003 |
| Outpatient | 295 (542) | 494 (909) | < 0.0001 | 143 (283) | 297 (592) | < 0.0001 |
| ED | 9 (3) | 86 (15) | < 0.0001 | 17 (6) | 71 (23) | < 0.0001 |
| Pharmacy | 34 (4) | 42 (3) | 0.0017 | 42 (6) | 52 (7) | < 0.0001 |
| Otherc | 27 (3) | 135 (11) | < 0.0001 | 14 (4) | 91 (26) | < 0.0001 |
| All-cause costs, mean (SD) $ PPPM | ||||||
| Total | 2428 (3034) | 10,470 (13,086) | < 0.0001 | 2991 (4731) | 7944 (12,582) | < 0.0001 |
| Hospitalization | 467 (238) | 6434 (276) | < 0.0001 | 1534 (715) | 4984 (1940) | < 0.0001 |
| Outpatient | 1182 (34) | 2162 (46) | < 0.0001 | 789 (1251) | 1549 (2456) | < 0.0001 |
| ED | 62 (17) | 244 (23) | < 0.0001 | 75 (25) | 213 (70) | < 0.0001 |
| Pharmacy | 507 (23) | 735 (27) | < 0.0001 | 525 (23) | 729 (27) | < 0.0001 |
| Otherc | 327 (27) | 943 (65) | < 0.0001 | 281 (48) | 1000 (216) | < 0.0001 |
ED emergency department, HCRU health care resource utilization, HF heart failure, HFrEF heart failure with reduced ejection fraction, PPPM per patient per month, SD standard deviation
aBy definition, the worsening assessment period had a duration of 12 months (365 days)
bBy definition, only patients with chronic HFrEF following a worsening HF event could have had an HF-related hospitalization during the worsening assessment period; therefore, a comparative assessment of number of hospitalizations during this period was not performed between patients with stable chronic HFrEF and patients with chronic HFrEF following a worsening HF event
cCosts in Other category were incurred from the following settings or types of care: telehealth nursing facility, skilled nursing facility, school, custodial care facility, homeless shelter, hospice, adult living care facility, Indian Health Service free-standing facility, Indian Health Service provider-based facility, tribal free-standing facility, tribal provider-based facility, ambulance (land), ambulance (air or water), independent clinic, prison-correctional facility, federally qualified health center, inpatient psychiatric facility, patient home, psychiatric facility, partial hospitalization, assisted living facility, community mental health center, group home, intermediate care facility for individuals with intellectual disability, mobile unit, residential substance abuse facility, temporary lodging, psychiatric residential treatment center, walk-in retail health clinic, nonresidential substance abuse facility, place of employment/worksite, mass immunization center, outpatient hospital off campus, comprehensive inpatient rehabilitation facility, comprehensive outpatient rehabilitation facility, end-stage renal disease facility, state/local public health clinic, rural health clinic, independent laboratory, birthing center, military treatment facility, inpatient long-term care, other inpatient care, and other/unknown