Estimation of total incremental health care costs in patients with atrial fibrillation in the United States - PubMed (original) (raw)

Estimation of total incremental health care costs in patients with atrial fibrillation in the United States

Michael H Kim et al. Circ Cardiovasc Qual Outcomes. 2011 May.

Abstract

Background: Detailed information on the cost burden of atrial fibrillation (AF) is limited. To provide an up-to-date estimate of the national cost of AF, we conducted a retrospective, observational cohort study using administrative claims from the MarketScan Commercial and Medicare Supplemental research data bases, 2004 to 2006.

Methods and results: Patients aged ≥20 years with ≥1 inpatient or ≥2 outpatient AF diagnoses in 2005 (first diagnosis=index) and ≥12 months' enrollment before and after index were selected. AF patients were propensity score-matched (1:1) with non-AF control subjects. Medical costs (2008 US$), including AF costs, other cardiovascular, and noncardiovascular costs, were examined over 1 year after index. National incremental costs of AF were based on age-/sex-specific AF prevalence projections for 2010. In total, 89 066 AF patients were matched to non-AF control subjects. Over 1 year, 37.5% of AF versus 17.5% of control subjects were hospitalized and 2.1% versus 0.1% died during hospitalization. For AF versus control subjects, mean annual inpatient costs per patient were 7841versus7841 versus 7841versus2622 (incremental cost, 5218),outpatientmedicalcostswere5218), outpatient medical costs were 5218),outpatientmedicalcostswere9225 versus 5629(5629 (5629(3596), and outpatient pharmacy costs were 3605versus3605 versus 3605versus3714 (-$109) (all P<0.001). The total incremental cost of AF was 8705perpatient.ThenationalincrementalcostofAFwas8705 per patient. The national incremental cost of AF was 8705perpatient.ThenationalincrementalcostofAFwas26.0 billion (AF, 6.0billion;othercardiovascular,6.0 billion; other cardiovascular, 6.0billion;othercardiovascular,9.9 billion; noncardiovascular, $10.1 billion). Cardiovascular costs were based on claims with a primary disease diagnosis and may be underestimates.

Conclusions: On the basis of current US age- and sex-specific prevalence data, the national incremental AF cost is estimated to range from 6.0to6.0 to 6.0to26.0 billion.

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