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)?


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.


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.


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.


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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