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Abstracts and presentations are embargoed for release at date and time of presentation or time of AHA/ASA news event. Information may not be released before then. Failure to honor embargo policies will result in the abstract being withdrawn and barred from presentation.
Poster Abstract PresentationsSession Title: Health Services/Outcomes

Abstract P370: Healthcare utilization in older adults with chronic heart failure and elevated depressive symptoms: Cardiovascular Health Study

Mercedes R Carnethon, Joseph A Delaney, Norrina B Allen, Clyde Yancy, Calvin Hirsch, Lesley Curtis
Circulation. 2014;129:AP370
Mercedes R Carnethon
Northwestern Univ, Chicago, IL
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Joseph A Delaney
Univ of Washington, Seattle, WA
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Norrina B Allen
Northwestern Univ, Chicago, IL
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Clyde Yancy
Northwestern Univ, Chicago, IL
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Calvin Hirsch
Univ of California at Davis, Sacramento, CA
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Lesley Curtis
Duke Univ, Durham, NC
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Abstract

Background: Elevated depressive symptoms (EDS) are common in adults with heart failure (HF) and their joint prevalence is associated with worse short- (1 year) and long-term health outcomes. The contribution of EDS to healthcare costs and utilization in a contemporary population of older adults with HF is unknown.

Hypothesis: Adults with HF who report EDS will have higher annual healthcare costs and use more resources than their counterparts without EDS.

Methods: Participants from the Cardiovascular Health Study who developed HF between baseline and the 11-year follow up and whose data were linked to Medicare Part A and Part B claims were included in the analysis (n=441). HF was adjudicated based on review of medical records and physician questionnaires. EDS was determined if participants scored ≥8 on the abbreviated Centers for Epidemiologic Studies Depression scale. Medicare payments were adjusted using the Medical Consumer Price Index and represented in 2009 dollars. Annual healthcare utilization (i.e., total provider visits, inpatient and outpatient visits) is based on Part B. Linear regression with robust variance estimation was used to determine the relationship of EDS with medical costs or provider counts adjusted for confounders.

Results: Participants were 75.9 years old (SD= 5.3), 55% female, 15% black, and 147 (33%) had EDS. Within 2 years, 19% of patients with EDS died vs. 14% in those without EDS. Differences in annual costs between participants with and without EDS were not statistically significant. However, participants with EDS had more provider visits than their counterparts (Table).

Conclusion: Despite adults with HF and EDS using more healthcare resources than those without EDS, expenditures did not differ. Higher short-term mortality in adults with EDS could be an explanation.


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  • Health services research
  • Heart failure
  • Quality of life
  • Author Disclosures: M.R. Carnethon: None. J.A. Delaney: None. N.B. Allen: None. C. Yancy: None. C. Hirsch: None. L. Curtis: None.

  • © 2014 by American Heart Association, Inc.
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March 25, 2014, Volume 129, Issue Suppl 1
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    Abstract P370: Healthcare utilization in older adults with chronic heart failure and elevated depressive symptoms: Cardiovascular Health Study
    Mercedes R Carnethon, Joseph A Delaney, Norrina B Allen, Clyde Yancy, Calvin Hirsch and Lesley Curtis
    Circulation. 2014;129:AP370, originally published March 19, 2014

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    Abstract P370: Healthcare utilization in older adults with chronic heart failure and elevated depressive symptoms: Cardiovascular Health Study
    Mercedes R Carnethon, Joseph A Delaney, Norrina B Allen, Clyde Yancy, Calvin Hirsch and Lesley Curtis
    Circulation. 2014;129:AP370, originally published March 19, 2014
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