Prognosis of chronic heart failure (CHF) continues to be poor, in spite of recent advances lack in therapy. One of the main reasons for this persistent bad prognosis is the not application of recommended drug therapy, perhaps due, at least in part, to the great prevalence of CHF and the complexity of treatment. Disease management programs have shown to improve therapy and prognosis in patients with CHF, decreasing hospital admissions and improving survival. Nevertheless, the cost-benefit effect and the economic impact of such programs are not well known. We performed a prospective trial involving 153 consecutive patients diagnosed of heart failure in 1999 in our hospital, and randomized in two groups: the intervention (n = 76) and the control group (n = 77). The interventional program was based on the information and education of the patient and its surrounding and the possibillity of free telephonic or personal consultation with our cardiologist. Patients from the control group received usual care. After 15.8 +/- 6 months of follow-up, a significant reduction of mortality, heart failure readmissions and hospital stay were observed in the intervention group. The total number of days of hospital stay was 593 in the control group and 114 days in the intervention group, avoiding 479 days of hospital stay in this group. Given a cost of the hospital stay of Euro 421.25/day, the total cost eluded was Euro 216,148.75 in 15.8 months, representing savings of Euro 163,953.4 in one year. The expenses of the program were Euro 2,645.91/month, resulting in savings of Euro 132,202.48/year. In conclusion, the cost to benefit ratio of our program is favorable.

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