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
AdvisorMalone, Daniel C.
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PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractCongestive 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.
Degree ProgramGraduate College