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July 5, 2023PLoS ONE8 citationsOpen Access

Financial burden of heart failure in Malaysia: A perspective from the public healthcare system

SOSiew Chin OngJLJoo Zheng Low

Key Result

The estimated mean annual healthcare cost per heart failure patient in Malaysia was USD 5,217, with inpatient costs accounting for 74.8% of the total costs and HFrEF driving the main economic burden.

Study Design

Type

Observational (n=329)

Multicenter

Yes

Structured PICO

P
Population
329 adult heart failure patients (extrapolated to 87,448 at the population level) treated in public tertiary healthcare institutions in Malaysia, mean age 54.6 years, 82.1% male.
O
Outcome
Annual direct cost of heart failure per patient and total economic burden on the public healthcare system

Heart failure imposes a substantial financial burden on Malaysia's public healthcare system, consuming approximately 1.05% of total health expenditure, driven primarily by inpatient costs and HFrEF patients.

Limitations

  • Calculated from the perspective of the public healthcare system only, and the indirect cost was not considered.
  • The direct cost associated with private healthcare institution follow-up was not considered.
  • The prevalence of HF in Malaysia used in this study was the estimated value for 2017, which may underestimate the 2021 prevalence.
  • Inherent limitations associated with retrospective data collection from patients' medical records.
  • Not all patients had complete cost data for one year of follow-up (censored patients)

Abstract

BACKGROUND: Estimating and evaluating the economic burden of HF and its impact on the public healthcare system is necessary for devising improved treatment plans in the future. The present study aimed to determine the economic impact of HF on the public healthcare system. METHOD: The annual cost of HF per patient was estimated using unweighted average and inverse probability weighting (IPW). Unweight average estimated the annual cost by considering all observed cases regardless of the availability of all the cost data, while IPW calculated the cost by weighting against inverse probability. The economic burden of HF was estimated for different HF phenotypes and age categories at the population level from the public healthcare system perspective. RESULTS: The mean (standard deviation) annual costs per patient calculated using unweighted average and IPW were USD 5,123 (USD 3,262) and USD 5,217 (USD 3,317), respectively. The cost of HF estimated using two different approaches did not differ significantly (p = 0.865). The estimated cost burden of HF in Malaysia was USD 481.9 million (range: USD 31.7 million- 1,213.2 million) per year, which accounts for 1.05% (range: 0.07%-2.66%) of total health expenditure in 2021. The cost of managing patients with heart failure with reduced ejection fraction (HFrEF) accounted for 61.1% of the total financial burden of HF in Malaysia. The annual cost burden increased from USD 2.8 million for patients aged 20-29 to USD 142.1 million for those aged 60-69. The cost of managing HF in patients aged 50-79 years contributed 74.1% of the total financial burden of HF in Malaysia. CONCLUSION: A large portion of the financial burden of HF in Malaysia is driven by inpatient costs and HFrEF patients. Long-term survival of HF patients leads to an increase in the prevalence of HF, inevitably increasing the financial burden of HF.

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Cite This Study

Ong et al. (2023) conducted an observational in Heart failure (n=329). Heart failure management was evaluated on Mean annual cost per patient (USD). The estimated mean annual healthcare cost per heart failure patient in Malaysia was USD 5,217, with inpatient costs accounting for 74.8% of the total costs and HFrEF driving the main economic burden.

synapsesocial.com/papers/6a10f8cfcfa01e990d9feca9https://doi.org/10.1371/journal.pone.0288035
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