AimsPsychological distress is prevalent among heart failure (HF) patients, yet its impact on healthcare expenditure and utilization remains understudied. The aim of this study was to investigate the prevalence of psychological distress in HF patients and its impact on healthcare expenditure and utilization.Methods and resultsWe analysed data from the Medical Expenditure Panel Survey from January 2016 to December 2021, focusing on adults diagnosed with HF. We assessed the prevalence of psychological distress using the Kessler 6 (K6) questionnaire and examined its association with healthcare utilization and expenditures through multivariate regression models, adjusting for relevant covariates. Among 10 681 886 HF patients, 6.8% experienced psychological distress. The mean age was 69.9 years, and 50% were female. Multivariable analysis revealed significant associations between psychological distress and smoking (adjusted odds ratio [aOR] 2.87), Charlson comorbidity index ≥3 (aOR 3.05), and sleep disorders (aOR 2.82). Protective factors included exercise (aOR 0.40), higher education (aOR 0.89) and higher income levels (middle‐income: aOR 0.19, high‐income: aOR 0.20). HF patients with psychological distress incurred significantly higher annual total expenses ($14 709, p < 0.01), with inpatient costs ($6014, p = 0.02) and office‐based expenses ($3993, p = 0.04) being notably elevated. Additionally, these patients exhibited more frequent annual emergency room visits (0.07 visits, p < 0.01), hospital discharges (0.2 discharges, p = 0.01), and nights spent in the hospital (1.4 nights, p < 0.01).ConclusionPsychological distress in HF patients is associated with significantly higher medical expenditure and healthcare utilization. These findings underscore the need for integrated care approaches and present possible areas for intervention to address this significant healthcare burden.

中文翻译：

---

心力衰竭患者的心理困扰：对医疗保健利用和支出的影响


目的心理困扰在心力衰竭 （HF） 患者中普遍存在，但其对医疗保健支出和利用的影响仍未得到充分研究。本研究的目的是调查 HF 患者心理困扰的患病率及其对医疗保健支出和利用的影响。方法和结果我们分析了 2016 年 1 月至 2021 年 12 月的医疗支出小组调查数据，重点关注被诊断患有 HF 的成年人。我们使用 Kessler 6 （K6） 问卷评估了心理困扰的患病率，并通过多变量回归模型检查了其与医疗保健利用和支出的关联，并调整了相关协变量。在 10 681 886 名 HF 患者中，6.8% 经历了心理困扰。平均年龄为 69.9 岁，其中 50% 为女性。多变量分析显示，心理困扰与吸烟 （校正比值比 [aOR] 2.87） 、查尔森合并症指数 ≥3 （aOR 3.05） 和睡眠障碍 （aOR 2.82） 之间存在显著关联。保护因素包括运动 （aOR 0.40）、高等教育 （aOR 0.89） 和较高收入水平 （中等收入： aOR 0.19， 高收入： aOR 0.20）。患有心理困扰的 HF 患者的年度总费用 （14 709 美元，p < 0.01） 显着增加，住院费用 （6014 美元，p = 0.02） 和办公室费用 （3993 美元，p = 0.04） 显着升高。此外，这些患者表现出更频繁的年度急诊室就诊 （0.07 次就诊，p < 0.01）、出院 （0.2 次出院，p = 0.01） 和住院夜晚 （1.4 晚，p < 0.01）。结论HF 患者的心理困扰与显著较高的医疗支出和医疗保健利用相关。 这些发现强调了综合护理方法的必要性，并提出了可能的干预领域，以解决这一重大的医疗保健负担。