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Open access
Research Article
11 December 2025

Healthcare cost and utilization before and after the development of significant tricuspid regurgitation by age, sex and race

Authors: David P Cork https://orcid.org/0009-0005-6541-8736, Frank Medina https://orcid.org/0009-0003-2324-8527, Lisa Kemp https://orcid.org/0000-0003-4039-1512, Prakriti Gaba, Alissa Dratch https://orcid.org/0000-0002-2315-979X, Rebecca Horn https://orcid.org/0000-0003-0806-6955, Shannon ME Murphy https://orcid.org/0000-0001-7429-9365, Sarah Mollenkopf https://orcid.org/0000-0001-9214-2492, Robert W Yeh https://orcid.org/0000-0002-0564-4468 [email protected], and Colin Barker https://orcid.org/0000-0002-7904-0501Author Info & Affiliations
Volume 15, Number 1
https://doi.org/10.57264/cer-2025-0146
PDFFormats

Abstract

Background: The impact of significant tricuspid regurgitation (sTR) on healthcare costs and utilization in real-world populations remains understudied. Aim: Describe healthcare costs and utilization before and after development of sTR and describe differences by patient demographic characteristics. Materials & methods: We conducted a retrospective, longitudinal descriptive study using a large database containing electronic health record and insurance claims data for US patients. Healthcare costs and utilization are summarized for up to 3 years prior to sTR and for 1 year after sTR. Results: Costs and utilization increased in the 3 years leading up to and the year after sTR. Costs were higher for patients who were: aged 50–79 years, male, and Black or Hispanic (p < 0.01). Cardiovascular hospitalizations were an important driver of costs in all groups. Patients aged 80 years and over, women, and Black nonHispanic patients had fewer outpatient visits to cardiac specialists in the year following sTR (p < 0.01). Conclusion: Healthcare costs and utilization of patients with TR increase as clinical disease progresses, with important differences by age, sex and race. Increasing recognition of signs of TR progression and improved outpatient cardiac specialty access may be important means to reduce heart failure hospitalization duration as well as overall costs.

Plain language summary

What is this article about?

Tricuspid regurgitation (TR) is a heart valve condition that can progress in terms of symptoms and severity over time. The purpose of this article is to understand if there are differences by age, sex and race/ethnicity in healthcare cost and visits leading up to and after severe or symptomatic (significant) TR disease.

What methodology was used in this study?

This is a retrospective observational study. Researchers identified a group of patients with significant tricuspid regurgitation (sTR) in a real-world database that has information from medical records and insurance claims and examined their demographic, baseline comorbidities, costs and healthcare visits in the study period.

What were the results?

Descriptive trends showed that healthcare costs and visits increased leading up to a patient’s sTR status date. There were differences in trends by demographic subgroup leading up to significant disease, specifically patients under age 80 years had higher costs and days in hospital but fewer outpatient cardiology visits than patients over age 80 years. Male patients had higher costs and healthcare visits overall compared with female patients. Lastly, Black and Hispanic patients had higher costs and healthcare utilization in most visit types compared with White patients. Most of these trends were consistent across demographic subgroups the year after clinical significance was reached for TR.

Why are these results important?

These results suggest that cost and healthcare visit patterns for patients with sTR are not the same for all patients and that some patients may experience a higher cost and healthcare visit burden than others. Understanding differences in patient cost and healthcare history may help improve clinical decision making at the time of sTR disease identification.

Supplementary Material

File (supplementary data.docx)

References

Papers of special note have been highlighted as: • of interest; •• of considerable interest
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