Heart Failure and Chronic Obstructive Pulmonary Disease
Heart Failure and Chronic Obstructive Pulmonary Disease
Individuals with chronic medical conditions, including HF and COPD, have higher rates of healthcare utilization when compared with age- and sex-matched healthy controls. This observation is consistent across healthcare systems globally despite variations in clinical practice patterns, the patient population being evaluated, the cost of tests and services employed, and the underlying strategy for provider reimbursement. Given that the natural history of both HF and COPD is characterized by frequent episodes of acute exacerbation, increased healthcare utilization is primarily attributable to unplanned admission for disease decompensation. This is particularly apparent in patients with more advanced symptoms and/or those with a dual diagnosis, who are at highest risk for hospitalization. Diagnostic testing, medications, out-patient clinical services, and medical provider visits also contribute significantly to system related costs for both disease states.
To provide granularity to this issue of increased healthcare utilization, in 2005, the US Congressional Budget Office confirmed that high-cost Medicare beneficiaries were responsible for 85% of the expenditures associated with this entitlement program but comprised only 25% of the beneficiaries. Moreover, 30% of high-cost beneficiaries had a combined diagnosis of HF and COPD and ~75% of this group had at least one hospitalization episode over the course of a given year. These findings highlight the impact of co-existent HF and COPD with respect to clinical outcomes, risk of hospitalization, and healthcare expenditures.
Understanding the type and frequency of healthcare utilization among patients with multiple chronic disease diagnoses is paramount to developing strategies which improve patient- and system-related outcomes. Developing such strategies entails a robust characterization of patients, their co-morbidities, and the mechanisms through which they interact. Given the high prevalence and risk of hospitalization among individuals with a combined COPD and HF diagnosis, interventions to reduce unscheduled admission can lead to major cost savings for healthcare systems. To achieve this end, an emphasis on chronic disease management strategies which encompass patient self-management and evidence-based treatment algorithms, and which reduce the frequency of disease exacerbation must be employed to ensure efficient resource utilization.
Economic Costs
Individuals with chronic medical conditions, including HF and COPD, have higher rates of healthcare utilization when compared with age- and sex-matched healthy controls. This observation is consistent across healthcare systems globally despite variations in clinical practice patterns, the patient population being evaluated, the cost of tests and services employed, and the underlying strategy for provider reimbursement. Given that the natural history of both HF and COPD is characterized by frequent episodes of acute exacerbation, increased healthcare utilization is primarily attributable to unplanned admission for disease decompensation. This is particularly apparent in patients with more advanced symptoms and/or those with a dual diagnosis, who are at highest risk for hospitalization. Diagnostic testing, medications, out-patient clinical services, and medical provider visits also contribute significantly to system related costs for both disease states.
To provide granularity to this issue of increased healthcare utilization, in 2005, the US Congressional Budget Office confirmed that high-cost Medicare beneficiaries were responsible for 85% of the expenditures associated with this entitlement program but comprised only 25% of the beneficiaries. Moreover, 30% of high-cost beneficiaries had a combined diagnosis of HF and COPD and ~75% of this group had at least one hospitalization episode over the course of a given year. These findings highlight the impact of co-existent HF and COPD with respect to clinical outcomes, risk of hospitalization, and healthcare expenditures.
Understanding the type and frequency of healthcare utilization among patients with multiple chronic disease diagnoses is paramount to developing strategies which improve patient- and system-related outcomes. Developing such strategies entails a robust characterization of patients, their co-morbidities, and the mechanisms through which they interact. Given the high prevalence and risk of hospitalization among individuals with a combined COPD and HF diagnosis, interventions to reduce unscheduled admission can lead to major cost savings for healthcare systems. To achieve this end, an emphasis on chronic disease management strategies which encompass patient self-management and evidence-based treatment algorithms, and which reduce the frequency of disease exacerbation must be employed to ensure efficient resource utilization.
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