Northwestern University, Chicago, IL 60611, USA.
Adv Ther. 2009 Sep;26(9):847-57. doi: 10.1007/s12325-009-0066-x. Epub 2009 Sep 19.
Atrial fibrillation (AF) has been shown to be associated with high healthcare costs; however, limited data are available from large-scale studies quantifying the overall cost burden of AF in the USA. We therefore aimed to provide an up to date estimate of the overall per-patient costs of AF in managed care organizations across the USA.
This retrospective cohort study used claims data from the Integrated Healthcare Information Systems National Managed Care Benchmark Database from January 2005 to December 2006. Patients included in the analysis were aged > or =20 years and had at least two outpatient AF-related claims without hospitalization, or a hospitalization with a primary or secondary discharge diagnosis of AF in 2005. AF-related inpatient and outpatient costs over 12 months from the initial outpatient claim or first hospitalization were examined. For secondary AF hospitalizations, incremental costs associated with AF were measured by comparing costs for patients with AF with a group of matched controls hospitalized without AF.
In total, 35,255 patients diagnosed as having AF (5008 with a primary AF diagnosis, 10,776 with a secondary AF diagnosis, 19,471 with outpatient-managed AF), and 20,571 controls without AF, were included in the analysis. Over 12 months, for primary AF hospitalization patients, inpatient costs were $11,306.53 and outpatient costs were $2826.78 (total $14,133.30) per patient. For hospitalized patients with secondary AF, incremental AF-related inpatient costs were $5181.19 and outpatient costs were $1376.33 (total $6557.52). For AF patients with outpatient management in 2005, 12-month AF-related costs were $2177.30 ($175.47 for AF hospitalizations in 2006 and $2001.85 for outpatient costs).
Overall costs of AF in the US managed care organizations are high. Costs are primarily due to inpatient expenses. Improved disease management strategies to reduce AF-related hospitalizations and decrease the overall cost burden of AF are needed.
已证实心房颤动（AF）与高额医疗保健费用相关；然而，来自美国大规模研究的量化 AF 整体成本负担的有限数据。因此，我们旨在提供美国管理式医疗组织中 AF 每位患者总体成本的最新估计。
这项回顾性队列研究使用了 2005 年 1 月至 2006 年 12 月来自综合医疗保健信息系统国家管理式医疗基准数据库的索赔数据。分析中纳入的患者年龄≥20 岁，在 2005 年至少有两次无住院的门诊 AF 相关索赔，或有一次与 AF 相关的主要或次要出院诊断的住院。从初始门诊索赔或首次住院起的 12 个月内，检查了 AF 相关的住院和门诊费用。对于继发性 AF 住院，通过比较有 AF 的患者与一组无 AF 住院的匹配对照患者的费用，衡量了 AF 相关的增量成本。
共纳入 35255 例诊断为 AF 的患者（5008 例原发性 AF 诊断，10776 例继发性 AF 诊断，19471 例门诊管理性 AF）和 20571 例无 AF 的对照患者。在 12 个月内，原发性 AF 住院患者的住院费用为 11306.53 美元，门诊费用为 2826.78 美元（总计 14133.30 美元）/每位患者。对于继发性 AF 住院患者，AF 相关的增量住院费用为 5181.19 美元，门诊费用为 1376.33 美元（总计 6557.52 美元）。对于 2005 年接受门诊管理的 AF 患者，12 个月的 AF 相关费用为 2177.30 美元（2006 年 AF 住院费用为 175.47 美元，门诊费用为 2001.85 美元）。
美国管理式医疗组织中 AF 的总体费用很高。成本主要来自住院费用。需要改善疾病管理策略，以减少 AF 相关住院和降低 AF 的整体成本负担。
