ABC | Volume 111, Nº1, July 2018

Original Article Stevens et al The Economic Burden of Heart Conditions in Brazil Arq Bras Cardiol. 2018; 111(1):29-36 Figure 1 – Potential comorbidity combinations accounted for. HF: heart failure; MI: myocardial infarction; AF: atrial fibrillation; HTN: hypertension. HTN HTN HTN HTN HTN HTN HTN HTN MI MI MI MI MI MI MI AF AF AF AF AF AF AF AF HF HF MI HF HF HF HF HF HF Figure 2 – Markov model for recently discharged heart failure (HF) patients. Alive HF hospitalization Other hospitalization Dead 38 months and showed the mortality risk to be the highest after hospital discharge, then decreasing over time. The mean number of HF-related and other (all cause) hospitalizations were based on a published meta-analysis 26 and estimated by the National Institute for Health Research. 24 Effectiveness parameters relating to risks of death and hospitalization for STS and TM interventions were based on the hazard ratios for all-cause mortality, all-cause hospitalizations and HF-related hospitalizations during the treatment period. The hazard ratios were estimated from the network meta-analysis by the National Institute for Health Research. 24 Health state utilities Health state utilities for SC, STS and TM treatment approaches were based on the previous economic model of TM strategies conducted in a published meta-analysis, 26 which used utilities of 0.612 and 0.662 for SC and STS/TM groups, respectively. As with previous economic analyses, a negative adjustment of 0.1 was applied to account for the disutility associated with HF-related hospitalizations. 24 Resource utilization and costs STS and TMconsist of threemain units of healthcare resources: • devices and equipment within the patient’s home, which include the device hub, peripherals and communication costs; • maintenance/monitoring in the STS or TM center; and • medical care units to deal with events or alerts, such as GP or nurse visits, or hospital-based outpatient visits. The units of resources making up the components of SC, STS and TM were based on the published literature, and unit costs were obtained from DATASUS, the Brazilian Ministry of Health’s data department. 32