Project: Heart failure and health system sustainability

Heart failure and health system sustainability
A European case study outlining how prioritising heart failure can help to build resilient and sustainable healthcare systems.

Why was this case study needed?

The HFPN developed this case study for the first global summit of the Partnership for Health System Sustainability and Resilience, which took place on 15–19 March 2021. The Partnership was founded by the World Economic Forum, London School of Economics and Political Science, and AstraZeneca

COVID-19 has tested health systems to and beyond their limits, exposing long-standing problems in cardiovascular care. The pandemic is likely to increase the demand on heart failure services even further. People with pre-existing heart failure are at high risk of deterioration when infected with COVID-19 and the virus may also cause heart failure in previously healthy people, leading to a ‘hidden’ cohort of new cases.

Heart failure is the main cause of preventable hospitalisations in Europe. Hospitalisations and inpatient care account for almost 90% of healthcare costs associated with heart failure. This case study argues that prioritising heart failure can help improve health system sustainability and resilience by reducing hospitalisations.

Download the case study

Preventing hospital admissions in heart failure

What does the case study recommend?

The case study builds on existing recommendations from the HFPN. It focuses on sustainability and resilience in five domains of the health system: governance; financing; service delivery; medications and technology; political support and public acceptability.

Health system governance

  • Develop formal strategies on heart failure with the safe reduction of hospital admissions a major strategic objective.
  • Establish centrally led, comprehensive heart failure audits to identify gaps, inequalities and opportunities for improvement.

Health system financing

  • Introduce reimbursement frameworks that encourage a shift in heart failure care from acute to community settings, and from units or outputs of care to desired patient outcomes.
  • Develop reimbursement models that seek to enable earlier diagnosis and more robust ongoing care delivered in primary care settings.

Service delivery

  • Accredit, fund and expand the heart failure specialist nurse role.
  • Develop formally approved clinical guidelines for heart failure and clear templates to guide local organisation of care.

Medications and technology

  • Routinely prescribe and review guideline-based heart failure medication, and support people with heart failure in understanding and adhering to their treatment.
  • Invest in integrated healthcare IT systems, ensuring that comprehensive patient data in heart failure can be routinely shared between settings.
  • Increase the implementation of telemedicine in ongoing heart failure care.

Political support and public acceptability

  • Launch awareness-raising campaigns in heart failure at all levels, including among healthcare professionals, people living with the syndrome and the public.

Project funding

The case study was produced by The Health Policy Partnership, HFPN secretariat, pro bono.

The Heart Failure Policy Network is made possible with financial support from AstraZeneca, Vifor Pharma and Novartis Pharma. The content produced by the Network is non-promotional and not biased to any specific treatment or therapy. All outputs are guided and endorsed by the Network’s members.