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Trends in heart failure costs for commercially insured patients in the United States (2006-2021).
Zheng, Jianwei; Abudayyeh, Islam; Rakovski, Cyril; Ehwerhemuepha, Louis; Mianroodi, Ahmad Rezaie; Patel, Jay N; Ihab, Alomari; Ani, Chizobam.
Afiliação
  • Zheng J; Department of Preventive and Social Medicine Internal Medicine Department, Charles R Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, USA. jianweizheng@cdrewu.edu.
  • Abudayyeh I; Schmid College of Science and Technology, Chapman University, Orange, CA, USA. jianweizheng@cdrewu.edu.
  • Rakovski C; Loma Linda Veteran Administration Healthcare, Loma Linda, CA, USA.
  • Ehwerhemuepha L; Internal Medicine Department, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.
  • Mianroodi AR; Schmid College of Science and Technology, Chapman University, Orange, CA, USA.
  • Patel JN; Children's Hospital of Orange County, Orange, CA, USA.
  • Ihab A; Schmid College of Science and Technology, Chapman University, Orange, CA, USA.
  • Ani C; Loma Linda Veteran Administration Healthcare, Loma Linda, CA, USA.
BMC Health Serv Res ; 24(1): 780, 2024 Jul 08.
Article em En | MEDLINE | ID: mdl-38977998
ABSTRACT

BACKGROUND:

Although prior research has estimated the overarching cost burden of heart failure (HF), a thorough analysis examining medical expense differences and trends, specifically among commercially insured patients with heart failure, is still lacking. Thus, the study aims to examine historical trends and differences in medical costs for commercially insured heart failure patients in the United States from 2006 to 2021.

METHODS:

A population-based, cross-sectional analysis of medical and pharmacy claims data (IQVIA PharMetrics® Plus for Academic) from 2006 to 2021 was conducted. The cohort included adult patients (age > = 18) who were enrolled in commercial insurance plans and had healthcare encounters with a primary diagnosis of HF. The primary outcome measures were the average total annual payment per patient and per cost categories encompassing hospitalization, surgery, emergency department (ED) visits, outpatient care, post-discharge care, and medications. The sub-group measures included systolic, diastolic, and systolic combined with diastolic, age, gender, comorbidity, regions, states, insurance payment, and self-payment.

RESULTS:

The study included 422,289 commercially insured heart failure (HF) patients in the U.S. evaluated from 2006 to 2021. The average total annual cost per patient decreased overall from $9,636.99 to $8,201.89, with an average annual percentage change (AAPC) of -1.11% (95% CI -2% to -0.26%). Hospitalization and medication costs decreased with an AAPC of -1.99% (95% CI -3.25% to -0.8%) and - 3.1% (95% CI -6.86-0.69%). On the other hand, post-discharge, outpatient, ED visit, and surgery costs increased by an AAPC of 0.84% (95% CI 0.12-1.49%), 4.31% (95% CI 1.03-7.63%), 7.21% (95% CI 6.44-8.12%), and 9.36% (95% CI 8.61-10.19%).

CONCLUSIONS:

The study's findings reveal a rising trend in average total annual payments per patient from 2006 to 2015, followed by a subsequent decrease from 2016 to 2021. This decrease was attributed to the decline in average patient costs within the Medicare Cost insurance category after 2016, coinciding with the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Additionally, expenses related to surgical procedures, emergency department (ED) visits, and outpatient care have shown substantial growth over time. Moreover, significant differences across various variables have been identified.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Cardíaca / Seguro Saúde Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: BMC Health Serv Res Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Cardíaca / Seguro Saúde Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: BMC Health Serv Res Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos