Abstract 12534: High Cost Burden of Atrial Fibrillation/Atrial Flutter in Older Patients (≥65 years) in the United States
Introduction: The prevalence of atrial fibrillation (AF) and atrial flutter (AFL) is predicted to double over the next 25 years and the aggregate cost of managing AF/AFL will increase as a result. There is limited information on the overall costs of AF/AFL and factors that contribute to these costs. We, therefore, evaluated the healthcare costs of a large group of real-word Medicare AF/AFL patients aged ≥65 years without heart failure (HF).
Methods: This retrospective cohort study used claims data from January 2004 to December 2007 from the US Thomson Reuters MarketScan® Medicare database. Patients aged ≥65 years with evidence of non-transient AF/AFL and ≥12 months' continuous enrollment (except for inpatient death) following the first (index) hospitalization were identified. Direct healthcare costs were evaluated over the 12 months post index hospitalization.
Results: A total of 17,519 patients with non-transient AF/AFL aged ≥65 years without HF were included (mean age 77.9 yrs; 52.5% men). Comorbidities were common, 82.9% of patients had hypertension, 26.9% coronary artery disease, 22.4% diabetes, 13.8% pulmonary disease and 9.0% ischemic stroke. Overall, 37.7% of patients were rehospitalized within 1 year and 7.4% of patients died in hospital. Annual total mean per patient costs were $31,699. Inpatient costs ($17,932) represented 57% of total costs. Among patients who died during hospitalization, costs were $23,079 for the fatal hospitalization. Costs for common causes of CV hospitalizations were high − e.g. mean per hospitalization costs for AF/other rhythm disorders were $7,847, for congestive heart failure $9,220, for coronary atherosclerosis $16,760 and for stroke $8,875. Outpatient costs were $13,766 per patient per annum, with costs for physician visits of $1,001, laboratory costs $315, other outpatient services $8,321, ER visits $330 and outpatient pharmacy $3,799.
Conclusions: The annual costs of US Medicare AF/AFL patients aged ≥65 years without HF are very high. Inpatient costs made up the majority of the total costs and costs were high in patients who had CV-related hospitalizations and in patients who died during hospitalization. Therapeutic strategies that decrease admissions should reduce the rising cost of managing such patients.
- © 2010 by American Heart Association, Inc.