@Article{CHD.2020.011709,
AUTHOR = {Ruben Willems, Fouke Ombelet, Eva Goossens, Katya De Groote, Werner Budts, Stéphane Moniotte, Michèle de Hosson, Liesbet Van Bulck, Arianne Marelli, Philip Moons, Julie De Backer, Lieven Annemans},
TITLE = {Long-Term Healthcare Utilization, Medical Cost, and Societal Cost in Adult Congenital Heart Disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {6},
PAGES = {399--429},
URL = {http://www.techscience.com/schd/v15n6/40498},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Cost-of-illness studies in Adult Congenital Heart Disease
(ACHD) have mainly been limited to hospitalizations. This is the first paper to
provide a comprehensive overview from a societal perspective including inpatient
and outpatient medical costs, and absenteeism- and unemployment-related societal costs. <b>Methods:</b> A retrospective longitudinal (2006–2015) database analysis
was performed in Belgium combining administrative and clinical databases
(n = 10,572). Trends in resource use and costs per patient year were standardized
to assess the impact of changes in the patient population composition. Generalized
Linear Mixed Models assessed the impact of age, sex, lesion complexity, and
time. Costs were converted to 2018 values. <b>Results:</b> Medical costs per patient
year increased from €3490 to €4536 with a milder increase in patients with
severe lesions. Although unemployment-related costs decreased, total societal
costs increased due to more long-term (≥1 yr) invalidity. An increase in long-term
invalidity was particularly found in patients ≥30 yrs and in patients with mild or
moderate lesions. Resource use (e.g., dental care, nursing care, physiotherapy,
emergency department) increased substantially in all patient groups over time. The
annual percentage of patients with severe lesions receiving any cardiac and specialized cardiac follow-up increased with respectively 11 and 13 percent points to 81% and 52%, with a simultaneous decrease in hospitalization rate. <b>Conclusion:</b>
Medical cost increases in ACHD are most pronounced in patients with mild and
moderate lesions, relatable to their higher age. Economic data are necessary to
allocate resources efficiently to ensure sustainable, qualitative care in an ageing
patient population with strong increases in medical and long-term invalidityrelated costs.},
DOI = {10.32604/CHD.2020.011709}
}