Case management program for patients with chronic heart failure: effectiveness in terms of mortality, hospital admissions and costs.
BACKGROUND
At 360 000 cases annually, heart failure is the most common main diagnosis in adults in German hospitals. Treating heart failure is expensive. This study tested whether patients in the case management program (CMP) "CorBene--Better Care for Patients With Heart Failure" have a lower mortality rate and lower hospital admission and readmission rates than patients receiving regular management.


METHODS
Routine data from a large German statutory health insurance company were analyzed. After propensity score matching, a total of 1202 patients (intervention group versus control group) were studied in relation to the endpoint "hospital admission and readmission rate" and the variables "annual physician contact rate," "mortality," and "inpatient treatment costs."


RESULTS
The intervention group showed a lower rate of hospital admission/readmission (6.2%/18.9% versus 16.6%/36.0%; p<0.0001 / p = 0.041). Mortality rates did not differ significantly (5.0% versus 6.7%; p = 0.217). Analysis of hospital admission data showed no significant differences between the groups in terms of length of hospital stay or costs for heart failure-related treatment per hospital stay. However, the average annual costs for inpatient treatment in the CMP group, at €222.22 per patient, were 67.5% lower than the equivalent costs in the control group (€683.88) (p<0.0001).


CONCLUSIONS
Fewer patients in the intervention group were admitted and readmitted to hospital, and lower inpatient treatment costs were identified. The physician contact rate was higher than in the control group.
Institute for Health-Economics & Health-Care Research, University of Applied Sciences, Cologne, Department of Internal Medicine, Heidelberg University Hospital at the Ruprecht-Karls-University, Cardiology and Angiology Center, Cologne, pronova BKK, Statutory Health Insurance, Cologne, Department of Cardiology, St. Marien-Hospital Hamm (teaching hospital of the University of Münster), Department of Cardiology, Angiology and Diabetology, Cologne-Merheim Hospital, Kliniken der Stadt Köln, Cologne.
Verena
V
Hendricks
Simone
S
Schmidt
Achim
A
Vogt
Detlef
D
Gysan
Volker
V
Latz
Ines
I
Schwang
Reinhard
R
Griebenow
Rainer
R
Riedel
D000368:Aged; D019090:Case Management / Q000706:statistics & numerical data*; D002908:Chronic Disease; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000191:economics* / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000191:economics* / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate