Mantovani Lorenzo G, Cozzolino Paolo, Ferrara Pietro, Virdone Saverio, Camm A John, Verheugt Freek W A, Bassand Jean-Pierre, Turpie Alexander G G, Hacke Werner, Kayani Gloria, Goldhaber Samuel Z, Goto Shinya, Pieper Karen S, Gersh Bernard J, Fox Keith A A, Haas Sylvia, van Eickels Martin, Kakkar Ajay K
Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy.
Laboratory of Public Health, Istituto Auxologico Italiano-IRCCS, 20165 Milan, Italy.
Healthcare (Basel). 2023 Feb 21;11(5):638. doi: 10.3390/healthcare11050638.
The management of atrial fibrillation (AF), the most common sustained arrhythmia, impacts healthcare resource utilization (HCRU). This study aims to estimate global resource use in AF patients, using the GARFIELD-AF registry. A prospective cohort study was conducted to characterize HCRU in AF patients enrolled in sequential cohorts from 2012 to 2016 in 35 countries. Components of HCRU studied were hospital admissions, outpatient care visits, and diagnostic and interventional procedures occurring during follow-up. AF-related HCRU was reported as the percentage of patients demonstrating at least one event and was quantified as rate-per-patient-per-year (PPPY) over time. A total of 49,574 patients was analyzed, having an overall median follow-up of 719 days. Almost all patients (99.5%) had at least one outpatient care visit, while hospital admissions were the second most frequent medical contact, with similar proportions in North America (37.5%) and Europe (37.2%), and slightly higher in the other GARFIELD-AF countries (42.0%; namely Australia, Egypt, and South Africa). Asia and Latin America showed lower percentages of hospitalizations, outpatient care visits, and diagnostic and interventional procedures. Analyses of GARFIELD-AF highlighted the vast AF-related HCRU, underlying significant geographical differences in the type, quantity, and frequency of AF-related HCRU. These differences were likely attributable to health service availability and differing models of care.
心房颤动（AF）是最常见的持续性心律失常，其管理会影响医疗资源利用（HCRU）。本研究旨在利用加菲尔德房颤（GARFIELD-AF）注册研究估算房颤患者的全球资源使用情况。进行了一项前瞻性队列研究，以描述2012年至2016年期间在35个国家按序贯队列纳入的房颤患者的HCRU情况。所研究的HCRU组成部分包括住院、门诊就诊以及随访期间发生的诊断和介入程序。房颤相关的HCRU报告为至少出现一次事件的患者百分比，并按每位患者每年的发生率（PPPY）随时间进行量化。共分析了49574例患者，总体中位随访时间为719天。几乎所有患者（99.5%）至少有一次门诊就诊，而住院是第二常见的医疗接触方式，在北美（37.5%）和欧洲（37.2%）比例相似，在其他加菲尔德房颤国家（即澳大利亚、埃及和南非，42.0%）略高。亚洲和拉丁美洲的住院、门诊就诊以及诊断和介入程序的比例较低。加菲尔德房颤研究的分析突出了与房颤相关的巨大HCRU，表明房颤相关HCRU在类型、数量和频率上存在显著的地域差异。这些差异可能归因于卫生服务的可及性和不同的护理模式。
