title: Heart failure patients receiving ACEIs/ARBs were less likely to be hospitalized or to use emergency care in the following year.
abstract: Angiotensin-converting enzyme inhibitors (ACEIs) have been shown to decrease morbidity and mortality in heart failure (HF) patients in randomized-controlled trials; observational studies have confirmed this benefit among patients discharged with HF. Investigating the benefit of ACEIs or angiotensin receptor blockers (ARBs) among general HF patients has important implications for quality-of-care measurement and quality initiatives. The objective of this study is to assess the impact of receipt of ACEIs/ARBs among patients with HF on hospitalization, emergency care, and healthcare cost during the following year. Using administrative data, we identified HF patients between 2000 and 2005 in a large health plan (n=2,396 patients). We conducted multivariate analysis to assess the impact of receipt of an ACEI/ARB on likelihood of hospitalization and emergency care, and on total healthcare cost. We found that patients who received ACEIs/ARBs were less likely to be hospitalized (odds ratio [OR]=0.82, p<.05) or use emergency care (OR=0.82, p<.05) in the following year. Receipt of ACEIs/ARBs was not associated with significantly increased cost. Incentivizing the receipt of ACEIs/ARBs in a general population with HF may be a suitable target for pay-for-performance programs, disease management programs, or newer complementary frameworks, such as value-based insurance design.
authors: IMS Health, Woodland Hills, CA, USA. judy.chen@us.imshealth.com
authors: Judy Ying
authors: JY
authors: Chen
authors: Ning
authors: N
authors: Kang
authors: Deborah Taira
authors: DT
authors: Juarez
authors: Irina
authors: I
authors: Yermilov
authors: Ronald S
authors: RS
authors: Braithwaite
authors: Krista A
authors: KA
authors: Hodges
authors: Antonio
authors: A
authors: Legorreta
authors: Richard S
authors: RS
authors: Chung
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006254:Hawaii; D006333:Heart Failure / Q000188:drug therapy*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007297:Inpatients; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors