Health Care Costs for Cardiovascular-Related Care High and Trending Upwards in the US

Cardiovascular-related hospitalizations, procedural utilization, and health care costs in the United States represent a high burden demonstrating upward trends across the past several years, according to study findings published in The American Journal of Cardiology.

Annual health care spending in the US in 2021 reached $4.3 trillion ($12,914/person), with hospital services as the largest category of related costs ($1.3 trillion). In the current study, investigators characterized trends in cardiovascular (CV)-related hospitalizations, health care costs, and procedural utilization.

The investigators conducted a retrospective analysis using discharge data and ICD-10 codes from the National Inpatient Sample (NIS) database 2016 to 2021 (costs adjusted and reported in 2023 dollars). The NIS is the largest all-payer, encounter-level database in the US for hospitalizations (about 7 million deidentified hospitalizations/year).

The investigators noted in 2021, the 4,687,370 cardiovascular-related hospitalizations in the US cost $108 billion. The highest costs, $18.5 billion, were accounted for by heart failure (HF), $11.2 billion by non-ST-elevation myocardial infarction (non-STEMI), and $10.9 billion by stroke. Adults aged at least 65 years accounted for 64% of all cardiac-related hospitalizations, and those aged 45 to 64 years accounted for 30% (55% men; 70% White; 16% Black; 9% Hispanic).

From 2016 to 2021, significant upward trends were noted in the following:

• HF
• Stroke
• Atrial fibrillation
• STEMI
• Chest pain
• Hypertensive emergency
• Ventricular tachycardia
• Aortic dissection
• Sudden cardiac death
• Pericarditis
• Supraventricular tachycardia
• Pulmonary heart disease

Total costs increased over $10 billion across the study period, although not linearly, with significant declines likely related to the COVID-19 pandemic in 2020. Total CV-related costs by 2030 may reach $131.3 billion.

Procedures most performed in all years included coronary, extracorporeal membrane oxygenation (ECMO), non-bypass peripheral vascular surgery, pacemaker replacement, and coronary artery bypass graft surgery (CABG).

Study limitations include ICD codes may underreport primary diagnoses, NIS data are event-level related to discharge with unclear interpretation of how readmissions affect the data, and the impact of the COVID-19 pandemic on hospitalizations and costs was undetermined.

“Overall, from the years 2016 to 2021, cardiovascular-related hospitalizations, costs, and procedures demonstrated upward trends,” the investigators wrote. “…cardiovascular disease remains a high burden in the hospital setting with tremendous health care costs.”

Disclosure: Some [or one] study author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on The Cardiology Advisor