Key result
Multidisciplinary AF care collaborative cuts inpatient admissions ~24% and lowers per-member costs.
Why the study?
High utilization of acute health care resources and costs for patients with new onset or recurrent atrial fibrillation presenting to the emergency department motivated a collaborative care improvement project.
Does a multidisciplinary collaborative care project reduce healthcare costs and inpatient admissions for patients with atrial fibrillation?
Does a multidisciplinary collaborative care project reduce healthcare costs and inpatient admissions for patients with atrial fibrillation?
Effect estimate: 17% reduction in total AF PMPM cost, 28% reduction in AF PMPM inpatient cost, 24% reduction in inpatient admissions
A multidisciplinary collaborative care pathway for atrial fibrillation significantly reduced healthcare costs and inpatient admissions.
Supports multidisciplinary AF models; extends collaborative care data but remains hypothesis-generating without RCTs.
Atrial fibrillation (AF) is an increasingly common cardiac arrhythmia. Many patients with new onset or recurrent AF present to the emergency department and are subsequently admitted to the hospital and seen by cardiology specialists for follow up. In an attempt to address this high utilization of acute health care resources, reduce costs, and improve patient care, our institution instituted a collaborative project between the departments of emergency medicine, cardiology, family medicine, and primary care internal medicine. The project team oversaw development of a new emergency department AF order set, encouraged utilization of a new oral anticoagulant (dabigatran), improved the primary care follow up connection, and deployed a multimodal education plan for primary care providers. Between 2012 and 2014, these interventions resulted in a 17% reduction in total AF per member per month (PMPM) cost, a 28% reduction in AF PMPM inpatient cost, and a 24% reduction in inpatient admissions for AF.
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Robelia et al. (2015) studied Atrial fibrillation. Multidisciplinary care improvement collaborative was evaluated on Total AF per member per month (PMPM) cost, AF PMPM inpatient cost, and inpatient admissions for AF (17% reduction in total AF PMPM cost, 28% reduction in AF PMPM inpatient cost, 24% reduction in inpatient admissions). A multidisciplinary care improvement collaborative for atrial fibrillation reduced total per member per month costs by 17%, inpatient costs by 28%, and inpatient admissions by 24%.
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