IN HOSPITAL COSTS AND LENGTH-OF-STAY IN PATIENTS WITH ACUTE HEART FAILURE

Heart failure (HF) hospitalization is a significant source of health care expenditures and has become more frequent as the population ages and medical care continues to improve survival. The retrospective cost analysis is undertaken from a health care payer perspective. The inclusion criterion was that the patients were admitted due to acute HF (AHF) to the Faculty Hospital Brno between June and Dec. 2006. In-patient care costs include rate of admission and stay in standard cardiology unit (SCU) and/or intensive care unit (ICU), medication, rates of investigations and interventions. The costs of daily care in ICU are counted according to TISS scores. Results are presented as mean values. The overall direct hospital cost of 282 patients (58% male, median 73.5 years) with AHF was € 883414 within 7 months. The mean hospital stay was 8.7 days, one-day cost was € 360 and total in-patient cost was € 3133. A half of all passed through both SCU and ICU; 30% only SCU and 20% only ICU. The mean length of stay in the SCU was 7.7 days with one-day cost of € 47.5 and total in-patient cost of € 366. The mean length of stay in the ICU was 3.6 days with one-day cost of € 390.4 and total in-patient cost of € 1405. The total cost of cardiac cathetrisations and revascularisation procedures by 48.6% patients was € 357087; the cost of antiarrhytmic interventions (in particular the cost of antiarrhytmic devices) which by 6% patients was € 175238. The hospital mortality associated with HF was more than 11%. AHF is associated with high costs during hospital admission; prevail revascularisation procedures (40.5%), stay in ICU (30.5%) and antiarrhytmic interventions (20%). Because of the ever-rising morbidity of patients with HF and increases in hospitalization, mortality and costs there is an obvious need to inform medical specialists about the costs of management of AHF.