One-Year Healthcare Utilization and Expenditures Among Patients with Clinically Significant Mitral Regurgitation in Taiwan

Cardiol Ther. 2023 Mar;12(1):159-169. doi: 10.1007/s40119-022-00294-2. Epub 2022 Dec 15.

Abstract

Introduction: Mitral regurgitation (MR) is characterized by systolic blood flow reversal from the left ventricle to the left atrium. A 2019 study indicated that in the USA, clinically significant MR (sMR) is associated with a substantial healthcare cost burden. In Taiwan, few data are available to describe the clinical characteristics, treatment patterns, and economic burden of patients with sMR.

Methods: Using the National Health Insurance Research Database (NHIRD), a national, detailed claims database of all 23 million residents of Taiwan, we conducted a retrospective cohort study to identify patients with sMR and quantify the impact of the disease on Taiwan's healthcare system. We classified patients with sMR into three cohorts based on disease etiology: functional MR (sFMR), degenerative MR (sDMR), and uncharacterized MR (sUMR).

Results: We compared patient characteristics across cohorts and estimated attributable healthcare utilization and costs during the 12-month follow-up period. Our research shows that in Taiwan, patients with sFMR were older, sicker, and presented at casualty (emergency department) more frequently than those with sDMR and sUMR. Meanwhile, patients with sDMR had the highest 12-month healthcare expenditures across the cohorts.

Conclusion: These findings are inconsistent with what has been shown in the USA, which warrants further investigation.

Keywords: Degenerative mitral regurgitation; Functional mitral regurgitation; Health economics; Healthcare costs; Heart valve disease; Mitral valve disease; Uncharacterized mitral regurgitation; Valvular disease.