Medical resource use and expenditure in patients with chronic heart failure: a population-based analysis of 88 195 patients

Nuria Farré, Emili Vela, Montse Clèries, Montse Bustins, Miguel Cainzos-Achirica, Cristina Enjuanes, Pedro Moliner, Sonia Ruiz, Jose Maria Verdú-Rotellar, Josep Comín-Colet

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© 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology Aims: Heart failure (HF) is one of the diseases with greater healthcare expenditure. However, little is known about the cost of HF at a population level. Hence, our aim was to study the population-level distribution and predictors of healthcare expenditure in patients with HF. Methods and results: This was a population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on 31 December 2012 (n = 88 195). We evaluated 1-year healthcare resource use and expenditure using the Health Department (CatSalut) surveillance system that collects detailed information on healthcare usage for the entire population. Mean age was 77.4 (12) years; 55% were women. One-year mortality rate was 14%. All-cause emergency department visits and unplanned hospitalizations were required at least once in 53.4% and 30.8% of patients, respectively. During 2013, a total of €536.2 million were spent in the care of HF patients (7.1% of the total healthcare budget). The main source of expenditure was hospitalization (39% of the total) whereas outpatient care represented 20% of the total expenditure. In the general population, outpatient care and hospitalization were the main expenses. In multivariate analysis, younger age, higher presence of co-morbidities, and a recent HF or all-cause hospitalization were independently associated with higher healthcare expenditure. Conclusions: In Catalonia, a large portion of the annual healthcare budget is devoted to HF patients. Unplanned hospitalization represents the main source of healthcare-related expenditure. The knowledge of how expenditure is distributed in a non-selected HF population might allow health providers to plan the distribution of resources in patients with HF.
Original languageEnglish
Pages (from-to)1132-1140
JournalEuropean Journal of Heart Failure
Issue number9
Publication statusPublished - 1 Sept 2016


  • Cost
  • Expenditure
  • Heart failure
  • Hospitalization
  • Resource utilization


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