Heart failure (HF) accounts for 5% of all emergency hospital admissions in the UK. To ensure cost-effectiveness, the potential for any intervention to reduce admissions must be balanced against its required investment. This economic analysis compared costeffectiveness of home- versus hospital-based exercise training as delivered within a randomised-controlled trial (RCT) for HF. The additional costs of delivering eight weeks of home- versus hospital-based training for 46 people with HF, within an established cardiac rehabilitation service, were balanced against emergency hospital admission costs incurred by home-training (n = 15), hospital-training (n = 15) and control (n = 16) groups over five years. The total cost of home-training was Great British Pounds 3,244.47 (Great British Pounds 196.53 per patient) -- much of which was a fixed cost attributed to producing the home-training package. Hospital-training cost Great British Pounds 3,656.06 (Great British Pounds 221.58 per patient). Over five years, total admission costs for controls (of Great British Pounds 157,305.23) were considerably higher than for both home- (Great British Pounds 115,735.43) and hospital- (Great British Pounds 108,117.51) training groups. In conclusion, both training programmes incurred similar costs, which were offset by a reduction in emergency admission costs, compared with controls. Although hospital-training offered greater potential for reducing admission costs, with larger patient numbers, the cost of home-training per patient would decrease, increasing its likelihood of being the more cost-effective option.

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