title: Health care and nonhealth care costs in the treatment of patients with symptomatic chronic heart failure in Spain.
abstract: OBJECTIVE
  Chronic heart failure is associated with high mortality and utilization of health care and social resources. The objective of this study was to quantify the use of health care and nonhealth care resources and identify variables that help to explain variability in their costs in Spain.
  
  
  METHODS
  This prospective, multicenter, observational study with a 12-month follow-up period included 374 patients with symptomatic heart failure recruited from specialized cardiology clinics. Information was collected on the socioeconomic characteristics of patients and caregivers, health status, health care resources, and professional and nonprofessional caregiving. The monetary cost of the resources used in caring for the health of these patients was evaluated, differentiating among functional classes.
  
  
  RESULTS
  The estimated total cost for the 1-year follow-up ranged from € 12,995 to € 18,220, depending on the scenario chosen (base year, 2010). The largest cost item was informal caregiving (59.1%-69.8% of the total cost), followed by health care costs (26.7%- 37.4%), and professional care (3.5%). Of the total health care costs, the largest item corresponded to hospital costs, followed by medication. Total costs differed significantly between patients in functional class II and those in classes III or IV.
  
  
  CONCLUSIONS
  Heart failure is a disease that requires the mobilization of a considerable amount of resources. The largest item corresponds to informal care. Both health care and nonhealth care costs are higher in the population with more advanced disease.
authors.affiliation: Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain. Electronic address: juan.delgado@salud.madrid.org.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Delgado
authors.affiliation: Departamento de Análisis Económico y Finanzas, Universidad de Castilla-La Mancha, Toledo, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Oliva
authors.affiliation: Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Llano
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Domingo
authors.initials: D
authors.lastname: Pascual-Figal
authors.affiliation: Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Sta. Cruz de Tenerife, Spain.
authors.forename: José J
authors.initials: JJ
authors.lastname: Grillo
authors.affiliation: Servicio de Cardiología, Hospital del Mar, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Comín-Colet
authors.affiliation: Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Díaz
authors.affiliation: Servicio de Cardiología, Hospital Infanta Cristina, Badajoz, Spain.
authors.forename: León
authors.initials: L
authors.lastname: Martínez de La Concha
authors.affiliation: Medtronic Ibérica, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Martí
authors.affiliation: Departamento de Análisis Económico y Finanzas, Universidad de Castilla-La Mancha, Toledo, Spain.
authors.forename: Luz M
authors.initials: LM
authors.lastname: Peña
mesh_terms: D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000639:trends*; D006333:Heart Failure / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D011446:Prospective Studies; D012016:Reference Values; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: Chronic heart failure; Coste sanitario; Coste social; Health care costs; Insuficiencia cardiaca crónica; Social costs