Key result
Diabetes mellitus in acute heart failure admissions was associated with higher overall costs, with the highest cost per day alive seen in HFpEF patients with DM ($3153; 95% CI 2332-4262).
Why the study?
Both heart failure and diabetes mellitus account for major healthcare expenditures, motivating an evaluation of inpatient expenditures and cost drivers in patients admitted with heart failure with and without diabetes.
Does comorbid diabetes mellitus increase inpatient costs in patients admitted with acutely decompensated heart failure?
Cohort (n=544)
Does comorbid diabetes mellitus increase inpatient costs in patients admitted with acutely decompensated heart failure?
Comorbid diabetes mellitus significantly increases inpatient costs and length of stay for patients admitted with acutely decompensated heart failure, regardless of ejection fraction.
DM may elevate inpatient costs in acute HF admissions; leaves open whether targeted interventions reduce expenditures in HFpEF.
Both heart failure (HF) and diabetes mellitus (DM) account for major healthcare expenditures. We evaluated inpatient expenditures and cost drivers in patients admitted with HF with and without DM. METHODS: We created a retrospective cohort of acutely decompensated HF patients, using linked data from cost accounting systems and electronic medical records. We stratified patients by LVEF into reduced ejection fraction (HFrEF, LVEF ≤40%) and preserved ejection fraction (HFpEF, LVEF >40%) groups and by DM status at admission. RESULTS: Our population had 544 people: 285 HFrEF patients (43.5% with DM) and 259 HFpEF patients (43.6% with DM). Patients with HFrEF and DM had the longest hospital stay (5.10 ± 5.21 days). Patients with HFrEF and DM had the highest hospitalization cost ($11 576 ± 15 818). HFrEF and HFpEF patients with DM had the highest cost, and cost per day alive was highest for HFpEF patients with DM [$3153 (95% CI 2332, 4262)]. CONCLUSION: Overall cost was higher for patients with DM, whether or not they were admitted with acute HF due to HFrEF or HFpEF. Cost per day alive for patients with DM continued to exceed corresponding costs for patients without DM, with HFpEF patients with DM having the highest cost.
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Olchanski et al. (2020) conducted a cohort in acutely decompensated heart failure (n=544). Diabetes mellitus vs. Without diabetes mellitus was evaluated on Inpatient expenditures and cost drivers. Diabetes mellitus in acute heart failure admissions was associated with higher overall costs, with the highest cost per day alive seen in HFpEF patients with DM ($3153; 95% CI 2332-4262).
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