Deshmukh Abhishek, Iglesias Maximiliano, Khanna Rahul, Beaulieu Tara
Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
Franchise Health Economics and Market Access, Johnson & Johnson Medical Devices, Irvine, California.
Heart Rhythm O2. 2022 Aug 4;3(5):577-586. doi: 10.1016/j.hroo.2022.07.010. eCollection 2022 Oct.
Atrial fibrillation (AF) is the most common heart rhythm disorder among adults and leads to substantial morbidity and mortality.
The purpose of the study was to provide current estimates on the incremental healthcare utilization and cost burden associated with incident AF diagnosis in the United States.
Adults with an incident diagnosis of AF (2017-2020) were identified using the Optum Clinformatics database. Propensity matching was employed to match patients with incident AF to a comparator group of non-AF patients on several demographic and clinical characteristics. Outcomes including 12-month all-cause and cardiovascular (CV)-related healthcare utilization, as well as the medical cost associated with health services use, were assessed. Logistic and general linear models were used to examine study outcomes. Sub-analyses were performed to determine the incremental AF burden by specific sex and racial/ethnic categories.
A total of 79,621 patients were identified in each cohort (AF and non-AF). As compared to the non-AF cohort, patients with AF had significantly higher all-cause inpatient visits (relative risk [RR] 1.77; 95% confidence interval [CI] 1.76-1.78), CV-related inpatient visits (RR 2.51; 95% CI 2:49-2:53), and CV-related emergency room visits (RR: 2.41; 95% CI 2:35-2:47). The mean total healthcare cost for patients with AF was $27,896 more (per patient per year) than the non-AF cohort ($63,031 vs $35,135, < .001).
Medical services utilization and cost were significantly higher among AF patients than non-AF patients. Early treatment is likely to be critical to addressing the considerable disease burden imposed by AF.
心房颤动(AF)是成年人中最常见的心律失常,会导致严重的发病率和死亡率。
本研究的目的是提供美国与新发AF诊断相关的医疗保健利用增量和成本负担的当前估计。
使用Optum临床信息数据库识别2017 - 2020年新发AF诊断的成年人。采用倾向匹配法,根据人口统计学和临床特征将新发AF患者与非AF患者的对照组进行匹配。评估包括12个月全因和心血管(CV)相关医疗保健利用以及与卫生服务使用相关的医疗成本等结果。使用逻辑回归和一般线性模型来检验研究结果。进行亚组分析以确定按特定性别和种族/族裔类别划分的AF增量负担。
每个队列(AF和非AF)共识别出79,621名患者。与非AF队列相比,AF患者的全因住院就诊率显著更高(相对风险[RR] 1.77;95%置信区间[CI] 1.76 - 1.78),CV相关住院就诊率(RR 2.51;95% CI 2.49 - 2.53),以及CV相关急诊就诊率(RR:2.41;95% CI 2.35 - 2.47)。AF患者的平均总医疗成本比非AF队列每年多27,896美元(63,031美元对35,135美元,P <.001)。
AF患者的医疗服务利用率和成本显著高于非AF患者。早期治疗可能对于应对AF所带来的巨大疾病负担至关重要。