Heart failure (HF) is one of the most common diagnoses on admission to hospital in Germany, and one which incurs high costs. Integrated care in case management programs (CMPs) aims to improve treatment quality in the sense of guideline-driven treatment, while reducing hospital admissions, hospital costs, and mortality. A total of 1,844 patient data records from 11 German statutory health insurance companies enrolled in the CMP (intervention group [IG]) were compared with 1,844 standard-care patients (control group) using propensity score matching. The two groups were assessed over three follow-up observation periods regarding the endpoints' treatment costs, hospitalization rate, indicators for treatment quality (diagnostics, physician contact), and mortality. The evaluation revealed no significant differences regarding overall costs. The IG incurred significantly higher outpatient costs, but the medication costs and inpatient costs were not significantly different. There were also no significant differences in the number of hospital admissions. Patients within the CMP had significantly more frequent contact with a cardiologist, and underwent echocardiographic examination significantly more frequently. Mortality during the first follow-up observation year was considerably more favorable for the IG. There are indications that treatment quality is improved in HF patients.

Ethical approval for this study was waived by the Ethics committee of the University Witten/Herdecke.

Statistical evaluations were performed by the Institute for Applied Health Research Berlin GmbH—InGef. An allowance was paid for data fusion and statistical evaluations. InGef is a subsidiary of spectrumK GmbH, which belongs to the Association of Professional and Guild Health Insurance Companies. Together with BNK Service GmbH—a subsidiary of the Professional Association of Cardiologists in Private Practice—spectrumK is one of the CorBene frame contract partners and responsible for participant management and billing control for the health insurance companies. Some of the health insurance companies participating in the evaluation are partners in the spectrumK GmbH company. The data underlying this article will be shared on reasonable request to the corresponding author.

J.E., H.J.N., and P.M.B. contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript. He discussed the results and contributed to the final manuscript. D.G. provided critical feedback and helped shape the research, analysis, and manuscript. M.M., F.G., W.H., and S.G. contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript.

Article published online:
09 February 2024

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