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Abstracts and presentations are embargoed for release at date and time of presentation or time of AHA/ASA news event. Information may not be released before then. Failure to honor embargo policies will result in the abstract being withdrawn and barred from presentation.
Poster Abstract PresentationsSession Title: Arrhythmia/Sudden Death

Abstract P004: Impact of Atrial Fibrillation on Healthcare Utilization in the Community: The Atherosclerosis Risk in Communities (ARIC) Study

Lindsay G Smith, Pamela L Lutsey, Laura R Loehr, Anna Kucharska-Newton, Lin Y Chen, Alanna M Chamberlain, Lisa M Wruck, Sue Duval, Sally C Stearns, Alvaro Alonso
Circulation. 2014;129:AP004
Lindsay G Smith
Univ of Minnesota, Minneapolis, MN
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Pamela L Lutsey
Univ of Minnesota, Minneapolis, MN
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Laura R Loehr
Univ of North Carolina, Chapel Hill, NC
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Anna Kucharska-Newton
Univ of North Carolina, Chapel Hill, NC
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Lin Y Chen
Univ of Minnesota, Minneapolis, MN
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Alanna M Chamberlain
Mayo Clinic, Rochester, MN
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Lisa M Wruck
Univ of North Carolina, Chapel Hill, NC
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Sue Duval
Univ of Minnesota, Minneapolis, MN
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Sally C Stearns
Univ of North Carolina, Chapel Hill, NC
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Alvaro Alonso
Univ of Minnesota, Minneapolis, MN
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Abstract

Background: Atrial fibrillation (AF) is associated with increased risk of hospitalization. However, little is known about the impact of AF on non-inpatient healthcare utilization or about sex or race differences in AF-related utilization. We examined rates of inpatient and outpatient utilization by AF status in the Atherosclerosis Risk in Communities (ARIC) study.

Methods and Results: ARIC cohort participants with incident AF enrolled in fee-for-service Medicare, Parts A and B, for at least 12 continuous months between 1991 and 2009 were matched on age, sex, race and center to up to three participants without AF. Healthcare utilization was ascertained from inpatient and outpatient Medicare claims and classified based on primary ICD-9 code. The analysis included 944 AF and 2,761 non-AF participants. The average number of days hospitalized per year was 13.1 (95% confidence interval [CI]: 11.5-15.0) and 2.8 (95% CI: 2.5-3.1) for those with and without AF, respectively. The corresponding number of outpatient claims per year was 53.2 (95% CI: 50.4-56.1) and 23.0 (95% CI: 22.2-23.8) for those with and without AF, respectively (Table). Most utilization in AF patients was attributable to non-AF conditions, particularly other-cardiovascular disease (CVD)-related reasons; the adjusted rate ratio for days hospitalized per year for other-CVD-related reasons was 4.76 (95% CI: 3.51 - 6.44) for those with compared to those without AF. There was suggestive evidence that sex modified the association between AF and inpatient utilization, with AF related to greater utilization in women than men. The association between AF and healthcare utilization was similar in whites and blacks.

Conclusions: This study highlights the considerably greater healthcare utilization (inpatient and outpatient) among those with AF; the differential in utilization due to other-CVD-related reasons was substantial. In addition to recommended heart rate or rhythm treatment, accompanying cardiovascular comorbidities should be evaluated and managed.


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  • Atrial fibrillation
  • Health services research
  • Author Disclosures: L.G. Smith: None. P.L. Lutsey: None. L.R. Loehr: None. A. Kucharska-Newton: None. L.Y. Chen: None. A.M. Chamberlain: None. L.M. Wruck: None. S. Duval: None. S.C. Stearns: None. A. Alonso: None.

  • This research has received full or partial funding support from the American Heart Association, National Center.

  • © 2014 by American Heart Association, Inc.
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    Abstract P004: Impact of Atrial Fibrillation on Healthcare Utilization in the Community: The Atherosclerosis Risk in Communities (ARIC) Study
    Lindsay G Smith, Pamela L Lutsey, Laura R Loehr, Anna Kucharska-Newton, Lin Y Chen, Alanna M Chamberlain, Lisa M Wruck, Sue Duval, Sally C Stearns and Alvaro Alonso
    Circulation. 2014;129:AP004, originally published March 19, 2014

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    Abstract P004: Impact of Atrial Fibrillation on Healthcare Utilization in the Community: The Atherosclerosis Risk in Communities (ARIC) Study
    Lindsay G Smith, Pamela L Lutsey, Laura R Loehr, Anna Kucharska-Newton, Lin Y Chen, Alanna M Chamberlain, Lisa M Wruck, Sue Duval, Sally C Stearns and Alvaro Alonso
    Circulation. 2014;129:AP004, originally published March 19, 2014
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