Cargando…

Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

BACKGROUND: Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). METHODS: This...

Descripción completa

Detalles Bibliográficos
Autores principales: Leon-Justel, Antonio, Morgado Garcia-Polavieja, Jose I., Alvarez-Rios, Ana Isabel, Caro Fernandez, Francisco Jose, Merino, Pedro Agustin Pajaro, Galvez Rios, Elena, Vazquez-Rico, Ignacio, Diaz Fernandez, Jose Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106851/
https://www.ncbi.nlm.nih.gov/pubmed/33964944
http://dx.doi.org/10.1186/s12955-021-01779-9
_version_ 1783689844696809472
author Leon-Justel, Antonio
Morgado Garcia-Polavieja, Jose I.
Alvarez-Rios, Ana Isabel
Caro Fernandez, Francisco Jose
Merino, Pedro Agustin Pajaro
Galvez Rios, Elena
Vazquez-Rico, Ignacio
Diaz Fernandez, Jose Francisco
author_facet Leon-Justel, Antonio
Morgado Garcia-Polavieja, Jose I.
Alvarez-Rios, Ana Isabel
Caro Fernandez, Francisco Jose
Merino, Pedro Agustin Pajaro
Galvez Rios, Elena
Vazquez-Rico, Ignacio
Diaz Fernandez, Jose Francisco
author_sort Leon-Justel, Antonio
collection PubMed
description BACKGROUND: Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). METHODS: This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. RESULTS: Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. CONCLUSIONS: A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-021-01779-9.
format Online
Article
Text
id pubmed-8106851
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-81068512021-05-10 Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost Leon-Justel, Antonio Morgado Garcia-Polavieja, Jose I. Alvarez-Rios, Ana Isabel Caro Fernandez, Francisco Jose Merino, Pedro Agustin Pajaro Galvez Rios, Elena Vazquez-Rico, Ignacio Diaz Fernandez, Jose Francisco Health Qual Life Outcomes Research BACKGROUND: Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). METHODS: This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. RESULTS: Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. CONCLUSIONS: A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-021-01779-9. BioMed Central 2021-05-08 /pmc/articles/PMC8106851/ /pubmed/33964944 http://dx.doi.org/10.1186/s12955-021-01779-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Leon-Justel, Antonio
Morgado Garcia-Polavieja, Jose I.
Alvarez-Rios, Ana Isabel
Caro Fernandez, Francisco Jose
Merino, Pedro Agustin Pajaro
Galvez Rios, Elena
Vazquez-Rico, Ignacio
Diaz Fernandez, Jose Francisco
Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
title Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
title_full Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
title_fullStr Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
title_full_unstemmed Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
title_short Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
title_sort biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106851/
https://www.ncbi.nlm.nih.gov/pubmed/33964944
http://dx.doi.org/10.1186/s12955-021-01779-9
work_keys_str_mv AT leonjustelantonio biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT morgadogarciapolaviejajosei biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT alvarezriosanaisabel biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT carofernandezfranciscojose biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT merinopedroagustinpajaro biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT galvezrioselena biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT vazquezricoignacio biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost
AT diazfernandezjosefrancisco biomarkersbasedpersonalizedfollowupinchronicheartfailureimprovespatientsoutcomesandreducescareassociatecost