Burden of new hospitalization for heart failure: a population-based investigation from Italy

Aims - Heart failure has been described as one of the emerging pandemic for the 21st century. This report aims to measure the burden of new hospitalization for heart failure in the population of an Italian region of nearly 10 million inhabitants. Methods and results - Data were retrieved from healthcare utilization databases covering the population of the Italian region of Lombardy. We identified patients who were for the first time hospitalized with a primary diagnosis of heart failure (hospitalized heart failure, HHF) during 2011. Incident HHF cases were used for measuring incidence rates and exploring mortality, re-hospitalizations and health care costs on the one-year time horizon after index hospitalization. Out-of-hospital mortality, hospitalizations and healthcare costs were also measured in a referent cohort free from heart failure hospitalization and matched 1:1 by gender and age with the HHF cohort. The overall HHF incidence rate was 32 and 20 events every 10,000 person-years in men and women respectively. The incidence increased steeply with age in both gender. Among newly hospitalized patients 7% died during hospitalization. Among survivors, cumulative out-of-hospital mortality and hospital readmission were respectively 24% and 59%. The average per capita cost was 11,000 euro, the main cost item being hospitalizations. Mortality, readmissions and costs experienced by HHF patients exceeded those of the referent cohort of 88%, 75% and 79% respectively. Conclusions -The main burden associated with HHF is related to hospitalizations. Effective treatment options that decrease hospitalization rates could reduce patients’ suffering and offer considerable cost savings