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Healthcare Performance for Patients With Heart Failure in Iran: Addressing the Tip of the Iceberg Publisher Pubmed



Gorgani F1 ; Naderian M1, 2 ; Khatibzadeh S3 ; Amin A4 ; Farzi Y1 ; Beyranvand MR5 ; Haghjoo M6 ; Modirian M1 ; Shahbal N7 ; Azmin M1 ; Shahraz S8
Authors
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Authors Affiliations
  1. 1. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Heller School of Social Policy and Management, Brandeis University, Waltham, MA, United States
  4. 4. Cardiogenetics Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  7. 7. School of Agriculture and Food Science, The University of Queensland, Brisbane, Australia
  8. 8. Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, United States

Source: BMC Health Services Research Published:2024


Abstract

Background: Chronic diseases, such as heart failure with reduced ejection fraction (HFrEF), remain significant factors in the healthcare burden in Iran. Healthcare systems must have comprehensive data on the current usage, costs, and quality of care to tackle these challenges and formulate strategic plans effectively. Methods: The study included 209 patients with a mean age of 58 years (SD = 16.5) who met the inclusion criteria of having an ejection fraction of less than 40% and a confirmed diagnosis of HFrEF. This study used nationally representative data to assess the healthcare usage, costs, and quality of HFrEF management in Iran. Results: The most used services were medication dispensing (76%) and outpatient visits (53%), while rehabilitation (3%) and homecare (2%) were used less frequently. The annual per-patient direct medical cost was $1,464, with $308 (21%) paid out-of-pocket (OOP). Hospitalization accounted for most of the total cost (68%), and pharmacy expenses comprised the largest portion of OOP payments (46%). Echocardiography was performed for 91.1% of patients upon admission. Only 71.6% of patients had arrangements for a cardiology visit within seven days following hospital discharge. Additionally, only 67.5% of patients received prescriptions for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and 85% were prescribed beta-blockers. Conclusion: Patients with heart failure in Iran face challenges in accessing adequate cardiac care, including a lack of care continuity and advanced cardiac services. The study provided an essential benchmark for future healthcare reform. © The Author(s) 2024.
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