Atrial fibrillation was associated with an excess annual total cost of $14,875 per patient compared to matched non-AFIB controls ($18,454 vs $3,579; p<0.01).
Case-Control (n=7,888)
Yes
What is the economic burden and comorbidity profile associated with atrial fibrillation in a privately insured population?
Atrial fibrillation imposes a substantial economic burden, with affected patients incurring approximately five times the annual direct medical costs of matched controls.
Effect estimate: Excess cost $14,875
Absolute Event Rate: 18454% vs 3579%
p-value: p=<0.01
OBJECTIVE: This study assesses the direct (medical and drugs) and indirect (work loss) annual costs associated with Atrial Fibrillation (AFIB) in a privately insured population. BACKGROUND: AFIB is the most common sustained rhythm disturbance, affecting 2. 3 million people in the United States. METHODS: Cost and co-morbidity measures for AFIB patients were compared to matched controls using a privately insured administrative database (including medical, drug, and disability claims) for 2 million enrollees, 1999-2002 from 16 employers across the United States. Patients with an AFIB diagnosis on at least two occasions were included in the co-morbidity analysis (n = 3944). A non-AFIB control sample was randomly selected with a 1: 1 ratio, with characteristics (i. e. , age, gender, health plan) matched to AFIB patients. Excess medical costs (i. e. , employer payments) were estimated for AFIB patients, defined as the difference in average annual costs between AFIB and control patients (n = 3944) ; excess work-loss costs were defined similarly for employees with available work-loss data (n = 603). Statistical significance in the descriptive analysis was measured by paired t-tests for cost, or Chi-square tests for co-morbidity comparisons. A two-part multivariate model of excess cost was further estimated to control for co-existing conditions and other patient characteristics. The excess costs of AFIB patients were estimated as the difference between the observed costs of AFIB patients and their estimated costs, assuming they did not have AFIB. RESULTS: The multivariate analysis found that the excess annual direct cost of AFIB was 12, 349 (p < 0. 01), with AFIB patients approximately 5 times as costly as non-AFIB individuals (15, 553 versus 3204, respectively). The excess annual total cost was 14, 875 (p < 0. 01), with AFIB patients again approximately 5 times as costly as non-AFIB individuals (18, 454 versus 3, 579, respectively). AFIB was associated with increased incidence of atrial flutter (p < 0. 01), heart failure (Relative Risk (RR) = 29, p < 0. 01), other arrhythmias/conduction disorders (RR = 16, p < 0. 01), heart attack (RR = 8, p < 0. 01), and stroke (RR = 6, p < 0. 01). CONCLUSIONS: AFIB is a costly disease and one for which more definitive therapies might offer some potential for reducing, not only the clinical impact, but also the economic burden of the disease.
Wu et al. (Thu,) conducted a case-control in Atrial Fibrillation (n=7,888). Atrial Fibrillation vs. Matched non-AFIB controls was evaluated on Annual total cost (Excess cost $14,875, p=<0.01). Atrial fibrillation was associated with an excess annual total cost of $14,875 per patient compared to matched non-AFIB controls ($18,454 vs $3,579; p<0.01).