The result of our recent original article surprised the researchers: the costs of managing patients with heart failure increase tenfold in exacerbation compared to prior time. The results were published in the Finnish medical science journal Duodecim on 23rd March 2023.
The costs of heart failure increase in Finland, although its prevalence declines. This is due to the increase in patient numbers. Each exacerbation of heart failure increases the costs of management. The costs of managing exacerbation accumulate mostly from specialized healthcare facilities.
The published study provides new information healthcare resource use and its costs in different phases of the disease. In addition, it describes regional prevalence in Finland. Data for this study was aggregated from the Care register for healthcare of the Finnish Institute for health and welfare. Each included patient had received at least two heart failure diagnoses during 2012-2019. These patients totaled 115,470.
Especially elderly people suffer from heart failure. Mortality is high. It is also one of the most common reasons for hospital admission.
Docent and Specialist in Internal Medicine and Cardiology, Markku Pentikäinen from HYKS Heart and Lung Center and the University of Helsinki states that information on the costs of treatment was an especially interesting finding.
According to the study, each exacerbation increased the costs of treatment. In exacerbation (hospital admission period and costs in the following month), the costs were almost tenfold compared to the prior time.
“So far, there has only been estimates of the number of patients and how much treatment costs. Now we have data. We have access to actual numbers regarding the amount of patients and their age in Finland. We can assess how resources are utilized in treatment”
Medaffcon’s Data Analysis Lead Iiro Toppila considers the information of exacerbation’s impact on costs most astounding. “First, we wondered if this could be right, and thus we reviewed the results. It turned out that the results were correct: costs tenfold at exacerbation”, tells Toppila.
Pentikäinen states that the study also helps the authorities. They can estimate what the cost of medicinal care is compared to hospital admission.
Medicinal care improves the prognosis of heart failure and reduces the need for hospitalisation. On the basis of this study, the use of medicinal care could be improved. Health technology developed to support self-care could also be helpful.
According to Pentikäinen, the average treatment periods of the patients were surprisingly long. The share of in-patient days in treatment was remarkable: in the first exacerbation, an average of 17 days and in the following exacerbation, 21 in-patient days on average.
“In our unit, most patients are discharged in little less than a week, which means that the treatment periods in other hospitals are much longer”, says Pentikäinen.
In our study, an in-patient period was considered as an exacerbation leading to a more serious phase of the disease. Approximately half of the patients suffered at least one exacerbation, mostly treated in specialized healthcare facilities. Exacerbations rarely appear unexpectedly; thus, preventing them could be possible. Preventing exacerbation would also decrease the costs of patient management.
The study was initiated by the pharmaceutical company Bayer. The article based on an aggregate data request, from which the research group obtained the data in late 2020. Medaffcon prepared the research questions.
“Plenty of data is available from the Finnish registries. One must know what to look for in order to receive an answer to the right questions”, says Sr. Scientific Advisor Liisa Ukkola-Vuoti.
According to Toppila, a single aggregate data request yielded tremendous results. The researcher is also intrigued to continue the study.
The study was carried out by Sr. Scientific Advisor Liisa Ukkola-Vuoti and Data Analysis Lead Iiro Toppila from Medaffcon, Health Economics & Outcome Research Manager Niina Säävuori and Senior Medical Advisor Anna Kirjavainen from pharmaceutical company Bayer, Chief Physician Heikki Ukkonen from Turku University Hospital and Chief Physician Markku Pentikäinen from HYKS Cardiology and Lung Center. The aggregate data was produced by THL analyst Visa Martikainen.
“Cooperation in this project was smooth and the process went nicely”, praises Pentikäinen.
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Biostatistician
Data Analysis Lead
MSc (Tech.)
+358 44 314 1597
iiro.toppila@medaffcon.fi
Iiro joined Medaffcon in March 2017 as a Biostatistician. For the preceding four years, he has worked as a research assistant in an academic study group, analyzing clinical and genetic patient data. Iiro holds a Master of Science degree in Technology in Bioinformation Technology.
Iiro’s strengths include his strong expertise in statistics and data-analysis, hands-on experience in working with sensitive patient data, and strong interdisciplinary communication skills with experts from various fields. In the field, he is particularly interested in the large data amounts made available with the revolution of technology and how the information received such data can potentially be utilized to draw concrete conclusions, both in order to understand the nature of diseases and to advance the goals of the pharmaceutical industry and patient treatment.
“Machine learning and AI-based solutions will have a major impact on the healthcare sector now and in the future. However, effectively utilizing the already collected and available health-data will have a higher importance in order to improve health-care”.
Sr. Scientific Advisor
PhD
liisa.ukkola-vuoti@medaffcon.fi
Liisa joined Medaffcon in January 2020. She has over ten years of experience of working as a scientific advisor and research scientist for private and public sector organizations. Liisa holds a PhD in medical genetics, and she mentions that especially the therapeutic areas related neurology and psychiatry appeal to her.
Liisa’s strengths include strong expertise on medical sciences and research, as well as on creating evidence-based content, because she also has experience of being a science book author. Establishing cross-scientific collaboration, scientific exchange, and creating networks are one of her key work philosophies.
One of her main professional interests is the secondary use of health-related data to create real-world-evidence in order to improve and develop treatment practices. ”Due to the unique registries and data lakes available in Finland, in principle all the required data is already available or accumulating all the time, which makes it important to utilize this real-world-data to improve patient care and general well-being.”