Short Stay Management of Acute Heart Failure
This timely book is a road map for defining the care of acute heart failure patients in the short stay or observation unit setting. Produced in collaboration with the Society of Chest Pain Centers, this book provides an understanding of the diverse medica
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The Economics and Reimbursement of Congestive Heart Failure Sandra Sieck
Introduction Cardiovascular disease (CVD) remains entrenched as the leading cause of mortality in the USA [1]. Although the overall death rates due to CVD have been decreasing due to the increased incorporation of evidence-based therapies, the overall incidence of heart failure (HF) has remained relatively unchanged over the last two decades while the prevalence of HF has increased [2]. Innovative and exciting new treatment options offer the promise of improvement in activity-limiting symptoms, enhanced quality of life, and possibly, reduced mortality. Yet the economic burden of HF continues to impose a staggering challenge to all segments of the healthcare system. This challenge is particularly prominent for the acute care facility in the era of tightening budgets, diminishing reimbursements, quality of care mandates, government regulation, and an aging population. While HF is indeed a chronic medical condition that physicians strive to optimally control, it is acute decompensated heart failure (ADHF) that most adversely affects the hospital’s balance between providing effective acute care to patients and sustaining the economic viability of the institution. As hospitals are faced with the relentless shift toward caring for only the most acutely ill patients, they will be forced to develop more efficient, efficacious, cost-minimizing, and evidence-based treatment paths in order to remain viable and competitive in the rapidly changing healthcare market place.
S. Sieck, RN, MBA (*) Sieck Healthcare Consulting, Mobile, AL, USA e-mail: [email protected] W. Frank Peacock (ed.), Short Stay Management of Acute Heart Failure, Contemporary Cardiology, DOI 10.1007/978-1-61779-627-2_2, © Springer Science+Business Media, LLC 2012
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Burden of Disease Heart failure represents approximately 7% of the total burden of all cardiovascular diseases (CVD) [3]. The absolute incidence of HF is estimated at 670,000 new cases in a year and is age-related (Fig. 2.1) [4, 5]. Gains in survival with current therapies have resulted in an increase in the overall prevalence of HF [6]. In 2005, HF prevalence was 5.3 million [7]. By 2006, the prevalence of HF in the USA increased to 5.8 million or roughly 2.6% of the adult population [2] (Fig. 2.2). While the disease does occur in all ages, it is predominantly a disease of the elderly, with incidence and prevalence increasing with age. Among 40–59 year olds, 1–2% has HF. In the 60–79 age range, the prevalence increases to 4.8% for women and 9.3% for men [8]. With the aging US population, the number of people with HF is likely to continue to increase. The increasing prevalence of HF also translates to substantial healthcare resource utilization. Almost 15 million office visits are attributable to HF [9]. HF is the most frequent Medicare diagnosis-related group (Medicare Severity or MS-DRG) payment system for hospital billing [10]. HF is responsible for more elderly hospitalizations than any other medical cond
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