title: Hospitalization costs for heart failure in people with type 2 diabetes: cost-effectiveness of its prevention measured by a simulated preventive treatment.
abstract: OBJECTIVE
  To estimate the cost-consequence of interventions to prevent hospitalizations for heart failure (HF) in people with type 2 diabetes.
  
  
  METHODS
  In HF events (63) from type 2 diabetes-related hospitalizations (N = 462) recorded in an Argentine hospital (March 2004-April 2005), we verified 1) the presence of one metabolic HF predictor (glycosylated hemoglobin [HbA1c] value) before hospitalization; and 2) in a simulation model, the resources needed for its prevention controlling such predictor during 6 months before and after the event. Sensitivity analysis of HF risk reduction, hospitalization cost, and cost of different treatments to achieve HbA1c 7% or less was performed with a Monte Carlo simulation (10,000 iterations).
  
  
  RESULTS
  HF represented 14% of hospitalizations, with a 44% rehospitalization rate for the same cause. Due to the total estimated cost for an HF hospitalization event was $437.31, the prevention attained using our simulated treatment was $2326.51. The number needed to treat to prevent an HF event under any of the proposed alternatives to reduce HbA1c would be 3.57 (95% confidence interval 2.00-16.67). The additional cost of the simulated treatment versus the real one oscillates between $6423.91 and $8455.68.
  
  
  CONCLUSIONS
  HbA1c control to reduce the number of HF events would be economically beneficial for health care payers.
authors.affiliation: Centro de Endocrinología Experimental y Aplicada, PAHO/WHO Collaborating Centre for Diabetes, La Plata, Argentina.
authors.forename: Joaquín E
authors.initials: JE
authors.lastname: Caporale
authors.forename: Jorge
authors.initials: J
authors.lastname: Elgart
authors.forename: Guillermina
authors.initials: G
authors.lastname: Pfirter
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez
authors.forename: Gloria
authors.initials: G
authors.lastname: Viñes
authors.forename: Jorge T
authors.initials: JT
authors.lastname: Insúa
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Gagliardino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D015415:Biomarkers / Q000097:blood; D003198:Computer Simulation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000191:economics* / Q000628:therapy; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006333:Heart Failure / Q000191:economics* / Q000209:etiology / Q000517:prevention & control; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D018803:Models, Economic; D009010:Monte Carlo Method; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D010359:Patient Readmission / Q000191:economics; D011314:Preventive Health Services / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human