Healthcare Costs for Acute Hospitalized and Chronic Heart Failure in South Korea: A Multi-Center Retrospective Cohort Study

Abstract

Purpose: Although heart failure (HF) is recognized as a leading contributor to healthcare costs and a significant economic burden worldwide, studies of HF-related costs in South Korea are limited. This study aimed to estimate HF-related costs per Korean patient per year and per visit.

Materials and methods: This retrospective cohort study analyzed data obtained from six hospitals in South Korea. Patients with HF who experienced ≥one hospitalization or ≥two outpatient visits between January 1, 2013 and December 31, 2013 were included. Patients were followed up for 1 year [in Korean won (KRW)].

Results: Among a total of 500 patients (mean age, 66.1 years; male sex, 54.4%), the mean 1-year HF-related cost per patient was KRW 2,607,173, which included both, outpatient care (KRW 952,863) and inpatient care (KRW 1,654,309). During the post-index period, 22.2% of patients had at least one hospitalization, and their 1-year costs per patient (KRW 8,530,290) were higher than those of patients who had only visited a hospital over a 12-month period (77.8%; KRW 917,029). Among 111 hospitalized patients, the 1-year costs were 1.7-fold greater in patients (n=52) who were admitted to the hospital via the emergency department (ED) than in those (n=59) who were not (KRW 11,040,453 vs. KRW 6,317,942; p<0.001).

Conclusion: The majority of healthcare costs for HF patients in South Korea was related to hospitalization, especially admissions via the ED. Appropriate treatment strategies including modification of risk factors to prevent or decrease hospitalization are needed to reduce the economic burden on HF patients.

Keywords: Heart failure; healthcare costs; hospitalization.

Fig. 1. Study design. BMI, body mass index; LVEF, left ventricular ejection fraction; eGFR, estimated glomerular filtration rate; NYHA, New York Heart Association; HF, heart failure.

Fig. 2. Subgroup analysis of healthcare expenditures per patient per year. US $1=1,170 Korean won (2016). BMI, body mass index; LVEF, left ventricular ejection fraction; eGFR, estimated glomerular filtration rate; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; TE, treatment experienced; ED, emergency department; NHI, National Health Insurance; OOP, out-of-pocket; ICD-10, International Classification of Disease, 10th edition; AF, atrial fibrillation.

Fig. 3. Sensitivity analysis of healthcare expenditures per patient per year. US $1=1,170 Korean won (2016). HF, heart failure.