Economic Burden of Heart Failure Hospitalizations in Canada: A Population-based Study

Abstract

Background: Heart failure (HF) is associated with significant mortality and morbidity and accounts for substantial health care resources. We examined hospitalization costs of patients with HF in Canada (excluding patients from Quebec and the Territories) between 2010/2011 and 2018/2019 and estimated future costs to 2039/2040.

Methods: We identified hospitalization records with a primary diagnosis of HF between 2010/2011 and 2018/2019. Concurrent hospitalizations were combined to identify episodes of care. Total hospitalization costs and costs per HF patient were calculated for each fiscal year of the study. All costs are presented in 2022 CAD$. Generalized linear models were used to project primary HF hospitalization episodes and costs to 2039/2040 on the basis of population projections from Statistics Canada.

Results: There were 436,160 hospitalization episodes with a primary diagnosis of HF. Between 2010/2011 and 2018/2019, HF episodes increased from 43,114 to 54,743, and number of patients increased from 34,960 to 44,567, and total hospitalization costs increased from $684.3 million to $776.0 million, resulting in a cumulative cost of $6.65 billion. Between 2019/2020 and 2039/2040, there are projected to be 1.69 million HF hospitalization episodes, costing the Canadian health care system $19.5 billion.

Conclusions: HF places a substantial economic burden on the Canadian health care system, which is likely to increase in the coming decades. Health system planning and policy solutions to identify, and reduce barriers to, HF therapies that are effective in preventing hospitalizations; and improved access to community-based services are needed to mitigate future costs.

Figure 1

Study cohort exclusion diagram.

Figure 2

Canadian predicted total heart failure hospitalization episodes (A) and costs (B) over time (excluding Quebec and Territories).