Baseline Patient-Reported Health Status Predicts Hospitalization Duration and Cost in Chronic Heart Failure

Background and Objectives: The study aims to evaluate the significance and independence of patient-reported outcomes (PROs) in predicting costs of hospitalized chronic heart failure (CHF) cases. Materials and Methods: This observational cross-sectional study included all adult patients with a physician-confirmed diagnosis of CHF who were randomly admitted to the cardiology department of a university emergency hospital from Bucharest, Romania, between July and September 2024. Upon admission, each patient filled in the validated Romanian version of the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ), and underwent clinical interview and examination, blood sampling and transthoracic echocardiography. Total hospitalization cost and hospitalization duration were the primary outcomes, while KCCQ Overall Summary Score (KCCQ-OSS) was the primary predictor variable in generalized linear modeling (GLM) with potential confounders. Results: The study included 171 CHF patients with an average age of 73.5 years and a predominance of women (55.0%), with a median total hospitalization cost of 1513 €/patient for a mean hospitalization duration of 8.7 days. Each 10-point decrease in KCCQ-OSS was significantly and independently associated with a 9.5% increase in expected hospitalization duration and each 10-point increase in KCCQ-OSS was significantly and independently associated with a 5.1% increase in expected hospitalization cost. Conclusions: This study demonstrates that KCCQ-OSS is a significant independent predictor of both hospitalization cost and duration in CHF. Incorporating KCCQ assessment may support early identification of high-risk, high-cost patients, guide resource allocation, and ultimately enhance patient-centered and value-based management strategies in CHF.