Financial burden of heart failure in a developing country: cost analysis from Manipal Heart Failure Registry, India

Ajit Singh, Sheetal Chauhan, Tom Devasia, Yeshwanth Rao Karkala, Ganesh Paramasivam, Prasad N. Shetty, Deepak Uppunda, Hashir Kareem

Research output: Contribution to journalArticle

Abstract

Aim: To estimate the comprehensive healthcare costs of heart failure (HF) and determine the utilization of healthcare resources (HRU) for 2 years following index hospitalization. Subjects and methods: The Manipal Heart Failure Registry (MHFR) is a prospective registry analyzing the financial burden and HRU in 610 patients with HF. Costs incurred by patients during 2 years following index hospitalization were estimated, and their association with socio-demographic and clinical factors were calculated. After 54 (8.8%) in-hospital mortalities, 556 patients were followed up for 2 years. Results: The mean age of the study cohort was 65.08 ± 13.6 years, and 245 (40.2%) were females. Based on the ejection fraction (EF), 506 (82.9%) patients were diagnosed as having HF with reduced EF. Average hospital stay during index admission was 5.3 ± 2.9 days. Total expenditure during index hospitalization was INR 36.3 million and during 2-year follow-up was INR 45.2 million. Average total expenditure per patient was INR 133,663. The average out-of-pocket expense was INR 82,766 and average health insurance coverage was INR 50,896. Difference in expenditure was significant (P < 0.05) between specific groups, i.e., etiologies, genders, HF phenotypes, age groups, and healthcare insurance types. Conclusion: Healthcare expenditure of patients with HF in India is much lower than for the western counterparts. Higher utilization of healthcare resources in HF patients with ischemic etiology, non-compliant to medications, and elderly (age > 60 years) was associated with increased expenses. Interventional procedures and implantations account for the bulk of the expenses in ischemic HF patients. Trial registration number: Clinical Trial Registry of India: CTRI/2017/11/010395; National Institute of Health (NIH) clinical trial no.: NCT03157219.

Original languageEnglish
JournalJournal of Public Health (Germany)
DOIs
Publication statusAccepted/In press - 01-01-2019

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International Normalized Ratio
Developing Countries
Registries
India
Heart Failure
Health Expenditures
Costs and Cost Analysis
Hospitalization
Clinical Trials
Comprehensive Health Care
Delivery of Health Care
Insurance Coverage
National Institutes of Health (U.S.)
Health Insurance
Hospital Mortality
Health Care Costs
Length of Stay
Cohort Studies
Demography

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Singh, Ajit ; Chauhan, Sheetal ; Devasia, Tom ; Karkala, Yeshwanth Rao ; Paramasivam, Ganesh ; Shetty, Prasad N. ; Uppunda, Deepak ; Kareem, Hashir. / Financial burden of heart failure in a developing country : cost analysis from Manipal Heart Failure Registry, India. In: Journal of Public Health (Germany). 2019.
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abstract = "Aim: To estimate the comprehensive healthcare costs of heart failure (HF) and determine the utilization of healthcare resources (HRU) for 2 years following index hospitalization. Subjects and methods: The Manipal Heart Failure Registry (MHFR) is a prospective registry analyzing the financial burden and HRU in 610 patients with HF. Costs incurred by patients during 2 years following index hospitalization were estimated, and their association with socio-demographic and clinical factors were calculated. After 54 (8.8{\%}) in-hospital mortalities, 556 patients were followed up for 2 years. Results: The mean age of the study cohort was 65.08 ± 13.6 years, and 245 (40.2{\%}) were females. Based on the ejection fraction (EF), 506 (82.9{\%}) patients were diagnosed as having HF with reduced EF. Average hospital stay during index admission was 5.3 ± 2.9 days. Total expenditure during index hospitalization was INR 36.3 million and during 2-year follow-up was INR 45.2 million. Average total expenditure per patient was INR 133,663. The average out-of-pocket expense was INR 82,766 and average health insurance coverage was INR 50,896. Difference in expenditure was significant (P < 0.05) between specific groups, i.e., etiologies, genders, HF phenotypes, age groups, and healthcare insurance types. Conclusion: Healthcare expenditure of patients with HF in India is much lower than for the western counterparts. Higher utilization of healthcare resources in HF patients with ischemic etiology, non-compliant to medications, and elderly (age > 60 years) was associated with increased expenses. Interventional procedures and implantations account for the bulk of the expenses in ischemic HF patients. Trial registration number: Clinical Trial Registry of India: CTRI/2017/11/010395; National Institute of Health (NIH) clinical trial no.: NCT03157219.",
author = "Ajit Singh and Sheetal Chauhan and Tom Devasia and Karkala, {Yeshwanth Rao} and Ganesh Paramasivam and Shetty, {Prasad N.} and Deepak Uppunda and Hashir Kareem",
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Financial burden of heart failure in a developing country : cost analysis from Manipal Heart Failure Registry, India. / Singh, Ajit; Chauhan, Sheetal; Devasia, Tom; Karkala, Yeshwanth Rao; Paramasivam, Ganesh; Shetty, Prasad N.; Uppunda, Deepak; Kareem, Hashir.

In: Journal of Public Health (Germany), 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Financial burden of heart failure in a developing country

T2 - cost analysis from Manipal Heart Failure Registry, India

AU - Singh, Ajit

AU - Chauhan, Sheetal

AU - Devasia, Tom

AU - Karkala, Yeshwanth Rao

AU - Paramasivam, Ganesh

AU - Shetty, Prasad N.

AU - Uppunda, Deepak

AU - Kareem, Hashir

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Y1 - 2019/1/1

N2 - Aim: To estimate the comprehensive healthcare costs of heart failure (HF) and determine the utilization of healthcare resources (HRU) for 2 years following index hospitalization. Subjects and methods: The Manipal Heart Failure Registry (MHFR) is a prospective registry analyzing the financial burden and HRU in 610 patients with HF. Costs incurred by patients during 2 years following index hospitalization were estimated, and their association with socio-demographic and clinical factors were calculated. After 54 (8.8%) in-hospital mortalities, 556 patients were followed up for 2 years. Results: The mean age of the study cohort was 65.08 ± 13.6 years, and 245 (40.2%) were females. Based on the ejection fraction (EF), 506 (82.9%) patients were diagnosed as having HF with reduced EF. Average hospital stay during index admission was 5.3 ± 2.9 days. Total expenditure during index hospitalization was INR 36.3 million and during 2-year follow-up was INR 45.2 million. Average total expenditure per patient was INR 133,663. The average out-of-pocket expense was INR 82,766 and average health insurance coverage was INR 50,896. Difference in expenditure was significant (P < 0.05) between specific groups, i.e., etiologies, genders, HF phenotypes, age groups, and healthcare insurance types. Conclusion: Healthcare expenditure of patients with HF in India is much lower than for the western counterparts. Higher utilization of healthcare resources in HF patients with ischemic etiology, non-compliant to medications, and elderly (age > 60 years) was associated with increased expenses. Interventional procedures and implantations account for the bulk of the expenses in ischemic HF patients. Trial registration number: Clinical Trial Registry of India: CTRI/2017/11/010395; National Institute of Health (NIH) clinical trial no.: NCT03157219.

AB - Aim: To estimate the comprehensive healthcare costs of heart failure (HF) and determine the utilization of healthcare resources (HRU) for 2 years following index hospitalization. Subjects and methods: The Manipal Heart Failure Registry (MHFR) is a prospective registry analyzing the financial burden and HRU in 610 patients with HF. Costs incurred by patients during 2 years following index hospitalization were estimated, and their association with socio-demographic and clinical factors were calculated. After 54 (8.8%) in-hospital mortalities, 556 patients were followed up for 2 years. Results: The mean age of the study cohort was 65.08 ± 13.6 years, and 245 (40.2%) were females. Based on the ejection fraction (EF), 506 (82.9%) patients were diagnosed as having HF with reduced EF. Average hospital stay during index admission was 5.3 ± 2.9 days. Total expenditure during index hospitalization was INR 36.3 million and during 2-year follow-up was INR 45.2 million. Average total expenditure per patient was INR 133,663. The average out-of-pocket expense was INR 82,766 and average health insurance coverage was INR 50,896. Difference in expenditure was significant (P < 0.05) between specific groups, i.e., etiologies, genders, HF phenotypes, age groups, and healthcare insurance types. Conclusion: Healthcare expenditure of patients with HF in India is much lower than for the western counterparts. Higher utilization of healthcare resources in HF patients with ischemic etiology, non-compliant to medications, and elderly (age > 60 years) was associated with increased expenses. Interventional procedures and implantations account for the bulk of the expenses in ischemic HF patients. Trial registration number: Clinical Trial Registry of India: CTRI/2017/11/010395; National Institute of Health (NIH) clinical trial no.: NCT03157219.

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