Comparing two distinct costing models for health economics of heart failure within a Swedish population-based cohort
4 affiliations
- 1Department of Research and Development, Region Halland, 301 80 Halmstad, Sweden.
- 2Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, 202 13 Malmö, Sweden.
- 3School of ITE, Halmstad University, 301 18 Halmstad, Sweden.
- 4Health Economics and Policy (HEPER), School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Göteborg, Sweden.
Abstract
Aims
To compare two healthcare costing models, Cost Per Patient and Patient Encounter Costing, in patients with heart failure, quantify differences in estimated healthcare costs, and identify factors associated with discrepancies between the models.Methods and results
A retrospective register study was conducted in Region Halland, southwest Sweden, including 3230 patients aged 40-90 years with heart failure diagnosed at least twice between 2013 and 2018 and alive during 2019. Healthcare utilization costs during 2019 were estimated using the Cost Per Patient and Patient Encounter Costing models. Linear regression analyses were used to identify factors associated with costs and differences between the models. The Cost Per Patient model estimated a mean annual cost of €10 341 compared with €9538 for the Patient Encounter Costing model. Hospital care accounted for 73% of total costs in both models. Although overall cost estimates were similar, differences in outpatient and primary care costs reached 22%. Higher costs in both models were associated with diabetes, elevated N-terminal pro B-type natriuretic peptide levels, and impaired kidney function. Differences between the models were primarily explained by primary care visits, inpatient care days, and N-terminal pro B-type natriuretic peptide levels. Sensitivity analyses using log-transformed costs yielded similar results.Conclusion
Both Cost Per Patient and Patient Encounter Costing methodologies were useful for estimating healthcare costs in heart failure. The models provide different perspectives on healthcare costs because they use different cost-allocation principles. These differences should be considered when selecting a costing methodology for healthcare evaluations.
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BibTeX
@article{agvall2026comparing,
title = {{Comparing two distinct costing models for health economics of heart failure within a Swedish population-based cohort}},
author = {Björn Agvall and Anders Halling and Håkan Nilsson and Awais Ashfaq and Pia Johansson},
journal = {European heart journal open},
year = {2026},
month = sep,
doi = {10.1093/ehjopen/oeag172},
url = {https://europepmc.org/article/PMC/PMC13717912},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparing two distinct costing models for health economics of heart failure within a Swedish population-based cohort
AU - Björn Agvall
AU - Anders Halling
AU - Håkan Nilsson
AU - Awais Ashfaq
AU - Pia Johansson
PY - 2026
DA - 2026/09/01
JO - European heart journal open
DO - 10.1093/ehjopen/oeag172
UR - https://europepmc.org/article/PMC/PMC13717912
AB - Aims To compare two healthcare costing models, Cost Per Patient and Patient Encounter Costing, in patients with heart failure, quantify differences in estimated healthcare costs, and identify factors associated with discrepancies between the models.Methods and results A retrospective register study was conducted in Region Halland, southwest Sweden, including 3230 patients aged 40-90 years with heart failure diagnosed at least twice between 2013 and 2018 and alive during 2019. Healthcare utilization costs during 2019 were estimated using the Cost Per Patient and Patient Encounter Costing models. Linear regression analyses were used to identify factors associated with costs and differences between the models. The Cost Per Patient model estimated a mean annual cost of €10 341 compared with €9538 for the Patient Encounter Costing model. Hospital care accounted for 73% of total costs in both models. Although overall cost estimates were similar, differences in outpatient and primary care costs reached 22%. Higher costs in both models were associated with diabetes, elevated N-terminal pro B-type natriuretic peptide levels, and impaired kidney function. Differences between the models were primarily explained by primary care visits, inpatient care days, and N-terminal pro B-type natriuretic peptide levels. Sensitivity analyses using log-transformed costs yielded similar results.Conclusion Both Cost Per Patient and Patient Encounter Costing methodologies were useful for estimating healthcare costs in heart failure. The models provide different perspectives on healthcare costs because they use different cost-allocation principles. These differences should be considered when selecting a costing methodology for healthcare evaluations.
SN - 2752-4191
ER -