{"id":1424,"date":"2014-02-24T00:00:00","date_gmt":"2014-02-24T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/"},"modified":"2023-06-14T19:26:07","modified_gmt":"2023-06-14T23:26:07","slug":"the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/","title":{"rendered":"The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study"},"content":{"rendered":"

Background<\/strong> — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural indicators and process measures have an impact on the cumulative healthcare costs.<\/p>\n

Research Design<\/strong> — In this retrospective cohort study using administrative databases in Ontario, Canada, the authors identified 1216 HF patients discharged alive after an acute care hospitalization in 2006 and treated at a HF clinic. The primary outcome was the cumulative 1-year healthcare costs. A hierarchical generalized linear model with a logarithmic link and gamma distribution was developed to determine patient-level and clinic-level predictors of cost. <\/p>\n

Results<\/strong> — The mean 1-year cost was $27,809 (range, $69 to $343,743). There was a 7-fold variation in the mean costs by clinic, from $14,670 to $96,524. Delays in being seen at a HF clinic were a significant patient-level predictor of costs (rate ratio 1.0015 per day; P<0.001). Being treated at a clinic with >3 physicians was associated with lower costs (rate ratio 0.78; P=0.035). Unmeasured patient-level differences accounted for 97.4% of the between-patient variations in cost. The between-clinic variation in costs decreased by 16.3% when patient-level factors were accounted for; it decreased by a further 49.8% when clinic-level factors were added.<\/p>\n

Conclusions<\/strong> — From a policy perspective, the wide spectrum of HF clinic structure translates to inefficient care. Greater guidance as to the type of patient seen at a HF clinic, the timeliness of the initial visit, and the most appropriate structure of the HF clinics may potentially result in more cost-effective care.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural indicators and process measures have an impact on the cumulative healthcare costs. Research Design — In this retrospective cohort study using administrative databases in Ontario, Canada, the authors identified 1216 HF patients discharged alive […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,40,61],"migration-helper-qa-sample-set":[],"class_list":["post-1424","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-cardiovascular-disease","topic-health-economics"],"acf":{"citation":"Wijeysundera HC, Austin PC, Wang X, Bennell MC, Abrahamyan L, Ko DT, Tu JV, Krahn M. Med Care<\/em>. 2014; 52(3):272-9. Epub 2014 Feb 24.","source_url":"","ices_scientist":[1133,1385,1146,17632],"site":[6733,6735],"research_program":[6742,6746],"news_release":[7337],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"73114329-D143-4E92-A465-2465A3999750","sitecore_item_name":"The-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge","sitecore_field_values":"{\n \"Title\": \"The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study\",\n \"Short title\": \"The effect of multidisciplinary heart\",\n \"Citation\": \"

Wijeysundera HC, Austin PC, Wang X, Bennell MC, Abrahamyan L, Ko DT, Tu JV, Krahn M. Med Care<\/em>. 2014; 52(3):272-9. Epub 2014 Feb 24.<\/p>\",\n \"Abstract\": \"

Background<\/strong> — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural indicators and process measures have an impact on the cumulative healthcare costs.<\/p>rn

Research Design<\/strong> — In this retrospective cohort study using administrative databases in Ontario, Canada, the authors identified 1216 HF patients discharged alive after an acute care hospitalization in 2006 and treated at a HF clinic. The primary outcome was the cumulative 1-year healthcare costs. A hierarchical generalized linear model with a logarithmic link and gamma distribution was developed to determine patient-level and clinic-level predictors of cost. <\/p>rn

Results<\/strong> — The mean 1-year cost was $27,809 (range, $69 to $343,743). There was a 7-fold variation in the mean costs by clinic, from $14,670 to $96,524. Delays in being seen at a HF clinic were a significant patient-level predictor of costs (rate ratio 1.0015 per day; P<0.001). Being treated at a clinic with >3 physicians was associated with lower costs (rate ratio 0.78; P=0.035). Unmeasured patient-level differences accounted for 97.4% of the between-patient variations in cost. The between-clinic variation in costs decreased by 16.3% when patient-level factors were accounted for; it decreased by a further 49.8% when clinic-level factors were added.<\/p>rn

Conclusions<\/strong> — From a policy perspective, the wide spectrum of HF clinic structure translates to inefficient care. Greater guidance as to the type of patient seen at a HF clinic, the timeliness of the initial visit, and the most appropriate structure of the HF clinics may potentially result in more cost-effective care.<\/p>\",\n \"Keywords\": \"{2D4FD690-91FE-48C9-BF72-5ED73D19D7A0}|{92E2791D-5DAB-4244-8A85-434D524D9A12}|{5B386094-8417-4B93-9D08-2F46BC0458AB}\",\n \"Related Products\": \"

News Release<\/h2>rn

Seven-fold variation in average costs of treating patients at multidisciplinary heart failure clinics across Ontario: ICES studyrelease<\/a><\/h3>\",\n \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}|{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}|{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}\",\n \"ICES Scientists\": \"{8C2597F4-2B41-4E87-9F28-6887C689651B}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{B3827152-93D1-4FB2-B106-590CB331A264}|{956599EC-5699-41D3-9375-E0B6C25B12D5}|{9EB22F72-67F1-409E-AB1B-D1C045367A84}\",\n \"Posted Date\": \"20140224T000000\",\n \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2014\/January\/The-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge"},"yoast_head":"\nICES | The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study<\/title>\n<meta name=\"description\" content=\"Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study\" \/>\n<meta property=\"og:description\" content=\"Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:26:07+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\\\/\",\"name\":\"ICES | The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2014-02-24T05:00:00+00:00\",\"dateModified\":\"2023-06-14T23:26:07+00:00\",\"description\":\"Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study","description":"Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study","og_description":"Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-14T23:26:07+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/","name":"ICES | The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2014-02-24T05:00:00+00:00","dateModified":"2023-06-14T23:26:07+00:00","description":"Background — Although multidisciplinary heart failure (HF) clinics are efficacious, it is not known how patient factors or HF clinic structural","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-multidisciplinary-heart-failure-clinic-characteristics-on-1-year-postdischarge-health-care-costs-a-population-based-study\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"The effect of multidisciplinary heart failure clinic characteristics on 1-year postdischarge healthcare costs: a population-based study"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/1424","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/news_release\/7337"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6746"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6742"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6735"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6733"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/17632"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1146"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1385"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1133"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=1424"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=1424"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=1424"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=1424"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=1424"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}