Race/Ethnicity Differences in Medicare Expenditures for HFpEF

Study Questions:

Is there a difference by race/ethnicity in Medicare expenditures following hospitalization for heart failure with preserved ejection fraction (HFpEF)?

Methods:

Records of patients in the Get With the Guidelines-Heart Failure registry were linked to Medicare data, and comparisons of payments, health care use, and cost ratio were made between race/ethnic groups. The primary outcomes were unadjusted Medicare inpatient payments for acute care services at index hospitalization, 30 days, and 1 year.

Results:

The cohort included 53,065 beneficiaries. Median Medicare cost for index hospitalization for the entire cohort was $7,241 and for readmissions at 30 days, $9,803, and 1 year, $17,456. At 30 days, costs were higher for blacks, and at 1 year, costs were 14% higher for blacks, 7%-8% higher for Hispanics, and 24%-25% higher for the other race category. Costs were not significantly different among Asians compared to whites. Rates of acute care use were greater among race/ethnic minorities. Socioeconomic status (SES) and hospital factors appeared to significantly impact the hospital variations in Medicare expenditures.

Conclusions:

Medicare costs are greater for race/ethnic minorities with HFpEF than for whites. This variability may reflect higher use of acute care services by minorities and variations in SES and hospital factors.

Perspective:

Improving transitions of care and outpatient management of patients with HFpEF may help minimize use of acute care services and ultimately impact cost of care.

Clinical Topics: Geriatric Cardiology, Heart Failure and Cardiomyopathies, Acute Heart Failure, Chronic Heart Failure

Keywords: Ethnic Groups, Health Expenditures, Heart Failure, Heart Failure, Diastolic, Hospitalization, Inpatients, Geriatrics, Medicare, Minority Groups, Outpatients, Patient Readmission, Stroke Volume


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