Associations between hemoglobin level, resource use, and medical costs in patients with heart failure: findings from HF-ACTION.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: Reports that patients with heart failure and anemia incur greater costs and medical resource use have relied largely on data with limited clinical detail. METHODS: HF-ACTION, a large trial of exercise training in heart failure, recorded hemoglobin at baseline. Medical resource use and hospital bills for inpatient and emergency department visits were collected throughout the study. We analyzed hemoglobin as a continuous variable to evaluate relationships with medical resource use and costs over 1 year. RESULTS: Among 1,763 patients with baseline hemoglobin levels, those with lower hemoglobin levels tended to be older, African American, and women and to have more severe heart failure. Lower hemoglobin was significantly associated with more hospital admissions, inpatient days, outpatient visits, and urgent care or emergency department visits (all P < .005, unadjusted). Although cost outliers influenced estimates, these observations were distributed across hemoglobin levels. Mean 1-year costs across hemoglobin levels defined as ≤ 11, >11-12, >12-13, >13-14, >14-15, and >15 g/dL were $21,106, $20,189, $16,249, $17,989, $13,216, and $12,492, respectively (P < .001, unadjusted). Significant associations remained after multivariable adjustment. CONCLUSIONS: Patients with lower baseline hemoglobin levels experienced progressively greater resource use and higher costs.

Full Text

Duke Authors

Cited Authors

  • Reed, SD; Li, Y; Ellis, SJ; Isitt, JJ; Cheng, S; Schulman, KA; Whellan, DJ

Published Date

  • October 2012

Published In

Volume / Issue

  • 18 / 10

Start / End Page

  • 784 - 791

PubMed ID

  • 23040114

Pubmed Central ID

  • PMC3579220

Electronic International Standard Serial Number (EISSN)

  • 1532-8414

Digital Object Identifier (DOI)

  • 10.1016/j.cardfail.2012.08.359


  • eng

Conference Location

  • United States