Health care and medication costs and use among older adults with heart failure

Kevin T. Stroupe, Evgenia Y. Teal, Michael Weiner, Irmina Gradus-Pizlo, D. Craig Brater, Michael D. Murray

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Background Heart failure disproportionately affects older adults for whom multiple medications are prescribed to prevent exacerbations and hospitalization. To target interventions effectively, it is important to understand the association of medication acquisition with health care utilization and costs. Methods We used electronic medical records from an urban public health care system to identify patients aged ≥50 years who had a diagnosis of heart failure. We assessed the association between inappropriate or appropriate medication supplies and hospitalization and costs using multivariable analyses that adjusted for demographic characteristics, prior health care use, health status, and insurance status. Results Total health care costs for treating 1554 patients with heart failure from 1996 to 2000 were $36.6 million (in 2000 dollars). Less than a third of patients received appropriate medication supplies (between 90% and 110% of the supplies needed) annually. Compared with patients with appropriate supplies, the odds of hospitalization were greater among those with undersupplies (odds ratio [OR] = 3.1; 95% confidence interval [CI]: 2.3 to 4.2; P <0.0001) or oversupplies (OR = 2.0; 95% CI: 1.7 to 2.4; P <0.0001). Total costs were 25% higher for patients with undersupplies (95% CI: 8% to 46%; P = 0.004) and 18% higher for those with oversupplies (95% CI: 7% to 30%; P = 0.0009) than for those with appropriate supplies. Conclusion Among adults with heart failure, inappropriate medication supplies were associated with increased hospitalization and higher costs. Monitoring medication supplies from electronic medical records may be a useful component of programs aiming to improve care while managing costs.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalAmerican Journal of Medicine
Volume116
Issue number7
DOIs
StatePublished - Apr 1 2004

ASJC Scopus subject areas

  • Medicine(all)

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