Annual costs attributed to atrial fibrillation management: cross-sectional study of primary healthcare electronic records

Eur J Health Econ. 2018 Nov;19(8):1129-1136. doi: 10.1007/s10198-018-0961-7. Epub 2018 Feb 20.

Abstract

Atrial fibrillation (AF) is the most common chronic arrhythmia, with increasing healthcare and economic burden and a prevalence which increases with progressive ageing. This study aims to describe overall annual costs per patient for management of non-valvular AF in a primary healthcare (PHC) setting and compare these costs between the groups of patients treated with vitamin K antagonists, antiplatelets or non-treated through a population-based study conducted with electronic health records. We analysed annual costs per person of 19,787 patients in 2012; PHC visits, hospital admissions, AF-related events requiring hospital admission, referrals to secondary specialists, sick leave, diagnostic tests and laboratory tests at PHC level, including INR determinations performed in PHC, and drug therapy. Higher costs of AF management were associated with increasing age, male sex, stroke and bleeding risks, comorbidities and occurrence of events associated to AF. The sensitivity analyses conducted showed that PHC visits and hospitalizations represented the most important part of overall costs for all patients.

Keywords: Atrial fibrillation; Costs; Electronic health records; Haemorrhage; Primary healthcare; Stroke.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Anticoagulants / economics*
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / economics*
  • Comorbidity
  • Cross-Sectional Studies
  • Diagnostic Techniques and Procedures / economics
  • Electronic Health Records / statistics & numerical data*
  • Female
  • Health Services / statistics & numerical data
  • Hemorrhage / chemically induced
  • Humans
  • Male
  • Middle Aged
  • Models, Economic
  • Patient Admission / economics
  • Primary Health Care / economics
  • Primary Health Care / statistics & numerical data
  • Referral and Consultation / economics
  • Referral and Consultation / statistics & numerical data
  • Sex Hormone-Binding Globulin
  • Sick Leave / economics
  • Stroke / economics
  • Stroke / etiology

Substances

  • Anticoagulants
  • Sex Hormone-Binding Globulin