Korean Circ J.  2021 Aug;51(8):681-693. 10.4070/kcj.2021.0029.

Economic Burden of Heart Failure in Asian Countries with Different Healthcare Systems

• Yingchoncharoen T
• Wu TC
• Choi DJ
• Ong TK
• Liew HB
• Cho MC

• KMID: 2519149
• DOI: http://doi.org/10.4070/kcj.2021.0029

Abstract

Background and Objectives
Heart failure (HF) poses substantial economic burden, primarily driven by high hospitalization and mortality rates. This study aimed to understand the economic burden of HF in 4 Asian countries under varying healthcare systems.
Methods
This was a non-interventional, retrospective study conducted in South Korea, Taiwan, Thailand and Malaysia through medical chart review. Eligible patients included those who had either ≥1 hospitalization or ≥2 outpatient visits from January 1st to December 31st, 2014, and at least one year of follow-up. Resource use and direct healthcare costs (adjusted to 2015 USD) of HF were assessed. HF costs for subgroups stratified by age and sex were assessed.
Results
A total of 568 patients were recruited from South Korea (n=200), Taiwan (n=200), Thailand (n=100) and Malaysia (n=68). The proportion of patients hospitalized ranged from 20.0% to 93.5% (South Korea 20.0%, Thailand 49.0%, Malaysia 70.6%, and Taiwan 93.5%). The overall annual HF cost per patient was $2,357, $4,513, $3,513 and $1,443 in South Korea, Taiwan, Thailand, and Malaysia, respectively; hospitalized HF care costs were $10,714, $4,790, $7,181 and $1,776, respectively. The length of stay was more than 12.2 days except in Malaysia. No specific trend was observed in subgroup analysis.
Conclusions
In Asia, HF poses significant economic burden and hospitalization has emerged as the major cost driver among healthcare costs. A streamlined treatment strategy reducing hospitalization rate can minimize the economic burden.

Keyword

Heart failure; Hospitalization; Health care costs; Length of stay; Cost of illness

Figure

• 

  Figure 1 Costs and resource use for hospitalized patients in four Asian countries.LOS = length of stay.

Reference

1. McMurray JJ, Adamopoulos S, Anker SD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012; 33:1787–1847. PMID: 22611136.

2. Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol. 2014; 63:1123–1133. PMID: 24491689.

3. Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002; 106:3068–3072. PMID: 12473553.

4. Sutherland K. Bridging the Quality Gap: Heart Failure. 1st ed. London: The Health Foundation;2010. p. 111.

5. Richard Hobbs FD. Clinical burden and health service challenges of chronic heart failure. Br J Gen Pract. 2010; 60:611–615. PMID: 20822695.

6. Cook C, Cole G, Asaria P, Jabbour R, Francis DP. The annual global economic burden of heart failure. Int J Cardiol. 2014; 171:368–376. PMID: 24398230.

7. Lee JH, Lim NK, Cho MC, Park HY. Epidemiology of heart failure in Korea: present and future. Korean Circ J. 2016; 46:658–664. PMID: 27721857.

8. Shimokawa H, Miura M, Nochioka K, Sakata Y. Heart failure as a general pandemic in Asia. Eur J Heart Fail. 2015; 17:884–892. PMID: 26222508.

9. Sakata Y, Shimokawa H. Epidemiology of heart failure in Asia. Circ J. 2013; 77:2209–2217. PMID: 23955345.

10. X-rates [Internet]. Newmarket: XE.com, Inc.;c2021. cited 2016. Available from https://www.x-rates.com/.

11. Reyes EB, Ha JW, Firdaus I, et al. Heart failure across Asia: Same healthcare burden but differences in organization of care. Int J Cardiol. 2016; 223:163–167. PMID: 27541646.

12. Kilgore M, Patel HK, Kielhorn A, Maya JF, Sharma P. Economic burden of hospitalizations of Medicare beneficiaries with heart failure. Risk Manag Healthc Policy. 2017; 10:63–70. PMID: 28546776.

13. The World Bank. GDP per capita (current US$) – United States [Internet]. Bretton Woods (NH): The World Bank Group;c2021. cited 2019 Apr 30. Available from https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=US&year_high_desc=false.

14. Kim AM, Cho S, Kim HJ, et al. Primary care patients' preference for hospitals over clinics in Korea. Int J Environ Res Public Health. 2018; 15:1119.

15. Lee H, Oh SH, Cho H, Cho HJ, Kang HY. Prevalence and socio-economic burden of heart failure in an aging society of South Korea. BMC Cardiovasc Disord. 2016; 16:215. PMID: 27832754.

16. Yang HY, Chiu WC, Huang JH, Hsu CY, Lin YK, Chen YJ. Analysis of 10-year nationwide population-based data on sex differences in hospitalization for heart failure. Heart Vessels. 2013; 28:721–727. PMID: 23089890.

17. Wu TY, Majeed A, Kuo KN. An overview of the healthcare system in Taiwan. London J Prim Care (Abingdon). 2010; 3:115–119.

18. Sakunphanit T. Series: Social Security Extension Initiatives in East Asia. Thailand: Universal Health Care Coverage Through Pluralistic Approaches [Internet]. Bangkok: International Labour Organization;2008. cited 2019 Apr 30. Available from https://www.ilo.org/public/libdoc/ilo/2008/108B09_340_engl.pdf.

19. Kang SM, Cho MC. Prognostic factors in hospitalization for heart failure in Asia. Heart Fail Clin. 2015; 11:543–550. PMID: 26462094.

20. Kwon S, Lee TJ, Kim CY. Republic of Korea Health System Review. Manila: WHO Regional Office for the Western Pacific;2015.

21. International Trade Administration. Healthcare resource guide: Malaysia [Internet]. Washington, D.C.: International Trade Administration;updated 2019 Oct 3. cited 2019 May 2. Available from https://2016.export.gov/industry/health/healthcareresourceguide/eg_main_108601.asp.