Hospitalization and Medical Cost of Patients with an Elevated Serum NT-proBNP Level and Effect of Institutional Team Approach

Purpose: We studies all-cause hospitalizations of patients with an elevated serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and evaluated the effects of team approaches for heart failure (HF) on them. Methods and Results: We extracted all adult patients with NT-proBNP = or >400 pg/ml measured between January and March 2012 in our institution as potential HF (pHF)-positive patients. We studied their all-cause hospitalization records during the past 3-year period. We also extracted all pHF-negative patients with NT-proBNP <400 pg/ml as controls and studied as well. We enrolled 432 pHF-positive and 485 pHF-negative patients with one or more hospitalization records. Compared to the pHF-negative patients, the pHF-positive patients had longer total hospitalization days (median [interquartile range], 30 [13–58] versus. 18 [8–39], P < .0001) and higher total medical cost for hospitalizations (2.42 [1.07–5.08] versus. 1.80 [0.79–3.65] million yen, P < .0001). In 401 pHF-positive patients who were followed for 3 years after starting interprofessional team approaches for HF patients in the institution, both total hospitalization days (32 [14–66] to 6 [0–31]) and medical cost for hospitalizations (2.62 [1.36–5.29] to 0.47 [0–2.35] million yen) showed marked reduction. Conclusions: Our results indicate the longer medical care and higher costs for all-cause hospitalizations of patients with potential HF in Japan. Team approaches for HF patients may reduce them.