Lifetime Healthcare and Long-Term Care Costs of Heart Failure: Estimates Using Administrative Data from Hospitalized Patients in the Netherlands.

Abstract

Background and objective: Heart failure (HF) is a complex clinical syndrome associated with high mortality and extensive healthcare use. Using longitudinal data, we aimed to estimate the lifetime healthcare and long-term care (LTC) use and costs of Dutch patients with HF.

Methods: We used linked administrative data on mortality, LTC, and healthcare use covering the entire Dutch population for the period 2013-2024. Newly diagnosed patients with HF were defined as patients who were not hospitalized for HF 2 years before their index hospitalization for HF in 2015. Using regression modeling, we estimated hospitalized patients' life expectancy and lifetime healthcare costs as a function of age, sex, comorbidity, and income (all costs were adjusted to 2021 values).

Results: We identified 21,011 unique hospitalized patients with HF (mean age 80 years), of whom 86% died during follow-up. Estimated lifetime total healthcare and LTC costs varied between €35,000 and €170,000, depending on patient characteristics. Lifetime LTC costs varied between €9000 and €50,000. While comorbidity affects life expectancy substantially, it did not have a strong impact on lifetime costs. Income level affects costs more than comorbidities, and lower-income groups incur higher lifetime LTC costs.

Conclusions: Despite people with lower incomes having shorter lifespans than those with higher incomes, their lifetime LTC costs are higher. However, people with higher incomes have higher hospital costs, partly owing to their longer life expectancy.