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Research

The current and future financial burden of hospital admissions for heart failure in Canada: a cost analysis

Dat T. Tran, Arto Ohinmaa, Nguyen X. Thanh, Jonathan G. Howlett, Justin A. Ezekowitz, Finlay A. McAlister and Padma Kaul
July 21, 2016 4 (3) E365-E370; DOI: https://doi.org/10.9778/cmajo.20150130
Dat T. Tran
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
MPH
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Arto Ohinmaa
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
PhD
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Nguyen X. Thanh
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
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Jonathan G. Howlett
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
MD
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Justin A. Ezekowitz
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
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Finlay A. McAlister
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
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Padma Kaul
School of Public Health (Tran, Ohinmaa, Thanh), University of Alberta; Institute of Health Economics (Ohinmaa, Thanh), Edmonton; Department of Medicine (Howlett), University of Calgary, Calgary; Department of Medicine (Ezekowitz, McAlister, Kaul), University of Alberta; Canadian VIGOUR Centre (Ezekowitz, McAlister, Kaul), University of Alberta, Edmonton, Alta.
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Article Figures & Tables

Figures

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  • Figure 1
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    Figure 1

    Prevalence rates of hospital admissions for heart failure (HF) in Canada, 2004-2013.

  • Figure 2
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    Figure 2

    Estimated admission costs for heart failure and number of heart failure patients, 2004-2013, and projected for 2014-2030 (in 2014 $ values). Error bars incidate 95% confidence intervals.

Tables

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    Table 1: Characteristics of heart failure patients admitted to hospital, 2004-2013 (excluding Quebec)
    Characteristic2004200520062007200820092010201120122013
    Admissions to hospital, no.43 10242 03941 03340 39040 89941 08441 58542 29843 16345 528
    Mean ELOS*, d      (SD)7.5
    (4.1)
    7.5
    (4.1)
    7.7
    (4.4)
    7.8
    (4.7)
    7.9
    (4.8)
    8.0
    (5.0)
    8.1
    (5.1)
    8.3
    (5.1)
    8.4
    (5.3)
    8.3
    (5.3)
    Median aLOS (IQR)6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    6
    (3-11)
    Patients34 31133 60032 87632 54233 00432 99533 14433 75334 36536 142
    Male/female ratio0.960.980.981.001.021.011.011.011.031.04
    Mean age, yr (SD)76.8
    (12.1)
    76.9 (12.4)77.1
    (12.3)
    77.1
    (12.5)
    77.2
    (12.5)
    77.1
    (12.7)
    77.6
    (12.4)
    77.6
    (12.5)
    77.8
    (12.6)
    77.9
    (12.7)
    Patient proportion by age group, yr,  %†
    < 608.89.28.89.09.29.08.48.68.58.6
    60-6913.513.713.513.813.714.514.013.813.714.0
    70-7929.828.727.827.127.026.225.725.124.623.8
    ≥ 8047.848.450.050.150.250.351.952.553.253.6
    Patient comorbidity,  %
    AMI11.711.712.011.912.711.611.611.110.59.6
    COPD19.519.420.119.720.520.221.021.120.720.2
    Dementia5.25.15.45.25.55.35.96.05.95.9
    Diabetes29.330.440.040.940.645.044.744.945.545.7
    Renal19.020.018.618.018.814.614.414.213.914.3
    Patients with > 1 admission, %17.917.717.817.417.417.618.218.418.618.8

    Note: aLOS = acute length of stay, AMI = acute myocardial infarction, COPD = chronic obstructive pulmonary diseases, ELOS = expected length of stay, IQR = interquartile range, SD = standard deviation.

    *Number of days in hospital assigned to each admission based on CIHI grouping methodology.

    †Total percentage may not be exactly 100% because of rounding

      • View popup
      Table 2: Annual hospital admission cost for patients admitted to hospital for heart failure (in 2014 dollar values)
      Characteristic2004200720102013
      Mean cost per patient, $9 67910 09210 52210 970
      Women, yr
          All ages9 5439 95010 37410 816
          < 6010 04410 47210 91811 383
          60-699 91710 33910 78011 239
          70-799 4989 90310 32510 765
          ≥ 808 7149 0859 4729 876
      Men, yr
          All ages9 81610 23410 67011 125
          < 6010 33110 77111 23011 709
          60-6910 20010 63511 08811 560
          70-799 77010 18610 62011 073
          ≥ 808 9639 3459 74310 158
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    The current and future financial burden of hospital admissions for heart failure in Canada: a cost analysis
    Dat T. Tran, Arto Ohinmaa, Nguyen X. Thanh, Jonathan G. Howlett, Justin A. Ezekowitz, Finlay A. McAlister, Padma Kaul
    Jul 2016, 4 (3) E365-E370; DOI: 10.9778/cmajo.20150130

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    The current and future financial burden of hospital admissions for heart failure in Canada: a cost analysis
    Dat T. Tran, Arto Ohinmaa, Nguyen X. Thanh, Jonathan G. Howlett, Justin A. Ezekowitz, Finlay A. McAlister, Padma Kaul
    Jul 2016, 4 (3) E365-E370; DOI: 10.9778/cmajo.20150130
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