Patient-reported outcome is associated with health care costs in patients with ischaemic heart disease and arrhythmia

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  • Rikke E Mols
  • Britt Borregaard, University of Southern Denmark
  • ,
  • Brian B Løgstrup
  • Trine B Rasmussen, From the Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital (A.D.K., S.E.B., B.G.N.), Faculty of Health and Medical Sciences (A.D.K., J.S.J., S.E.B., B.G.N.), The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital (A.D.K., S.E.B., B.G.N.), Department of Medicine and Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital (J.S.J.), and The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhage
  • ,
  • Lars Thrysoee, University of Southern Denmark
  • ,
  • Charlotte B Thorup, Department of Cardiology, Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark. Electronic address: cbt@rn.dk.
  • ,
  • Anne V Christensen, 1Copenhagen University Hospital, Copenhagen, Denmark. 2Aarhus University Hospital, Aarhus, Denmark. 3University of Copenhagen, Copenhagen, Denmark. 4Odense University Hospital, Odense, Denmark.
  • ,
  • Ola Ekholm, University of Southern Denmark
  • ,
  • Anne A Rasmussen
  • Hans Eiskjær
  • Bettina W Risør
  • ,
  • Selina K Berg, 1Copenhagen University Hospital, Copenhagen, Denmark. 2Aarhus University Hospital, Aarhus, Denmark. 3University of Copenhagen, Copenhagen, Denmark. 4Odense University Hospital, Odense, Denmark.

AIMS: Systematic use of patient-reported outcomes (PROs) have the potential to improve quality of care and reduce costs of health care services. We aimed to describe whether PROs in patients diagnosed with heart disease are directly associated with health care costs.

METHODS AND RESULTS: A national cross-sectional survey including PROs at discharge from a heart centre with 1-year follow-up using data from national registers. We included patients with either ischaemic heart disease (IHD), arrhythmia, heart failure (HF), or valvular heart disease (VHD). The Hospital Anxiety and Depression Scale, the heart-specific quality of life, the EuroQol five-dimensional questionnaire, and the Edmonton Symptom Assessment Scale were used. The economic analysis was based on direct costs including primary, secondary health care, and medical treatment. Patient-reported outcomes were available from 13 463 eligible patients out of 25.241 [IHD (n = 7179), arrhythmia (n = 4322), HF (n = 987), or VHD (n = 975)]. Mean annual total direct costs in all patients were €23 228 (patients with IHD: €19 479, patients with arrhythmia: €21 076, patients with HF: €34 747, patients with VDH: €48 677). Hospitalizations contributed overall to the highest part of direct costs. For patients discharged with IHD or arrhythmia, symptoms of anxiety or depression, worst heart-specific quality of life or health status, and the highest symptom burden were associated with increased economic expenditure. We found no associations in patients with HF or VHD.

CONCLUSION: Patient-reported outcomes at discharge from a heart centre were associated with direct health care costs in patients with IHD and arrhythmia.

Original languageEnglish
JournalEuropean Journal of Cardiovascular Nursing
ISSN1474-5151
DOIs
Publication statusE-pub ahead of print - 11 May 2022

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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