• The effect of beta-blocker therapy, ACE inhibitor therapy,and digoxin therapy on the risk of hospitalization and resource utilizationamong patients with congestive heart failure enrolled in a managed care organization

      Malone, Daniel C.; Abarca, Jacob (The University of Arizona., 2001)
      Congestive heart failure (CHF) represents the end-stage of all heart disease. The current incidence of CHF in the US is 550,000 cases per year and is expected to increase in the future. Therapy with β-blockers, ACE inhibitors, and digoxin has been associated with a decreased risk of all-cause hospitalization and CHF-related hospitalization in randomized clinical trials. The purpose of this study was to evaluate the effect of beta-blocker, ACE inhibitor, and digoxin therapy on these outcomes and total direct medical costs among patients with CHF enrolled in a managed care plan. Neither therapies were associated with a statistically significant reduction in CHF-related hospitalizations. ACE inhibitor therapy (180 days) was associated with a significant decrease (34.7 percent, p < 0.0001) in the risk of all-cause hospitalization and lower total direct medical costs ($2135, p < 0.001) over a one year period. The results suggest increased use of ACE inhibitors is warranted.