BACKGROUND Heart failure (HF) imposes a large burden on both the individual and the society. The aim of this study was to investigate the economic burden (either direct or indirect costs) attributed to patients with HF before, at, and after time of diagnosis. METHODS AND RESULTS Using Danish nationwide registries we identified all patients > 18 years with a first-time diagnosis of HF from 1998-2016 and matched them 1:1 with a control group from the background population on age, gender, marital status, and educational level. The economic analysis of the total costs after diagnosis was based on direct costs including hospitalization, procedures, medication, and indirect costs including social welfare and lost productivity to estimate the annual cost of HF. A total of 176 067 HF patients with a median age of 76 (interquartile range 67-84) years and 55% male were included. Patients with HF incurred an average of €17 039 in total annual direct (€11 926) and indirect (€5113) healthcare costs peaking at year of diagnosis compared to €5936 in the control group with the majority attributable to inpatient admissions. The total annual net costs including public transfer after index HF were €11 957 higher in patients with HF compared to controls and the economic consequences were evident more than 2 years prior to the diagnosis of HF. CONCLUSION Patients with HF impose significantly higher total annual healthcare costs compared to a matched control group with findings evident more than 2 years prior to HF diagnosis.

中文翻译：

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1998年至2016年丹麦心力衰竭的经济负担。

背景技术心力衰竭（HF）给个人和社会都带来了沉重的负担。这项研究的目的是调查在诊断前，诊断时和诊断后由HF引起的经济负担（直接或间接费用）。方法和结果使用丹麦全国性注册机构，我们从1998-2016年首次确定所有18岁以上首次诊断为HF的患者，并将他们与年龄，性别，婚姻状况和教育程度的背景人群进行了1：1匹配等级。诊断后总成本的经济分析是基于直接成本（包括住院，手术，药物治疗）和间接成本（包括社会福利和生产力损失）来估算HF的年度成本。总共包括176067名HF患者，中位年龄为76岁（四分位间距为67-84岁），男性为55％。HF患者在诊断时平均每年直接，间接（5,113欧元）的总医疗费用为17 039欧元，而诊断组则为5936欧元，其中大部分是住院患者。与对照组相比，HF患者包括HF之后的包括公共转移在内的年度总净成本比对照组高11 957欧元，并且在诊断为HF之前两年以上，其经济后果明显。结论与相匹配的对照组相比，心力衰竭患者的年度总医疗保健费用明显更高，而在心力衰竭诊断前两年多的时间里发现。HF患者在诊断时平均每年直接，间接（5,113欧元）的总医疗费用为17 039欧元，而诊断组则为5936欧元，其中大部分是住院患者。与对照组相比，HF病人包括HF在内的包括公共转移在内的年度总净成本比对照组高11 957欧元，并且在诊断HF之前两年多就产生了明显的经济后果。结论与相匹配的对照组相比，心力衰竭患者的年度总医疗保健费用明显更高，而在心力衰竭诊断前两年多的时间里发现。HF患者在诊断时平均每年直接，间接（5,113欧元）的总医疗费用为17 039欧元，而诊断组则为5936欧元，其中大部分是住院患者。与对照组相比，HF患者包括HF之后的包括公共转移在内的年度总净成本比对照组高11 957欧元，并且在诊断为HF之前两年以上，其经济后果明显。结论与相匹配的对照组相比，心力衰竭患者的年度总医疗保健费用明显更高，而在心力衰竭诊断前两年多的时间里发现。与对照组相比，HF病人包括HF在内的包括公共转移在内的年度总净成本比对照组高11 957欧元，并且在诊断HF之前两年多就产生了明显的经济后果。结论与相匹配的对照组相比，心力衰竭患者的年度总医疗保健费用明显更高，而在心力衰竭诊断前两年多的时间里发现。与对照组相比，HF患者包括HF之后的包括公共转移在内的年度总净成本比对照组高11 957欧元，并且在诊断为HF之前两年以上，其经济后果明显。结论与相匹配的对照组相比，心力衰竭患者的年度总医疗保健费用明显更高，而在心力衰竭诊断前两年多的时间里发现。