Clinical and Economic Burden of Chronic Heart Failure and Reduced Ejection Fraction Following a Worsening Heart Failure Event

Figures

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  Fig. 1. Study design. The study population included adult patients aged less than 65 years who were diagnosed with prevalent or incident HFrEF. The first claim of HFrEF recorded from January 1, 2016 to December 31, 2016 was defined as the HFrEF index date. The 12-month period prior to the HFrEF index date was defined as the baseline period. The 12-month period after the HFrEF index date was defined as the worsening assessment period and was used to identify a worsening heart failure event based on the presence of heart failure-related hospitalization and/or intravenous diuretic use. The worsening assessment period was followed by an additional 12-month follow-up defined as the post-worsening assessment period. Abbreviations: HFrEF, heart failure with reduced ejection fraction; IV, intravenous

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  Fig. 2. Adjusted HCRU in the worsening and post-worsening assessment periods. HCRU was reported by setting of care (hospitalization, outpatient, and emergency department) for patients with stable chronic HFrEF versus patients with chronic HFrEF following a worsening HF event, and reported separately for HF-related and all cause-related services. HCRU data were adjusted with the following baseline demographic and clinical characteristics: gender, geographic region, health plan type, modified Charlson Comorbidity Index, HF medication use within 90 days prior to the index date, and HCRU during the 12-month baseline period (all-cause hospitalizations and outpatient visits). Abbreviations: ED, emergency department; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; HCRU, health care resource utilization; SD, standard deviation. aP < 0.0001 for difference between patients with stable chronic HFrEF and patients with chronic HFrEF following a worsening HF event. bBy definition, only patients with chronic HFrEF following a worsening HF event could have had an HF-related hospitalization during the worsening assessment period; therefore, a comparative assessment of number of…

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  Fig. 3. Adjusted costs in the worsening and post-worsening assessment periods. Costs are reported by setting of care (hospitalization, outpatient, emergency department, pharmacy, and other) for patients with stable chronic HFrEF versus patients with chronic HFrEF following a worsening HF event, and reported separately for HF-related and all cause-related services. Costs were adjusted with the following baseline demographic and clinical characteristics: gender, geographic region, health plan type, modified Charlson Comorbidity Index, HF medication use within 90 days prior to the index date, and HCRU during the 12-month baseline period (all-cause inpatient and outpatient visits). Abbreviations: ED, emergency department; HCRU, health care resource utilization; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; SD, standard deviation; US$, United States dollars. aP < 0.0001 for difference between patients with stable chronic HFrEF and patients with chronic HFrEF following a worsening HF event. bP = 0.0006 for difference between patients with stable chronic HFrEF and patients with chronic HFrEF following a worsening HF event. cBy definition, only patients with chronic…