Healthcare Utilization and Expenditures in Patients with Atrial Fibrillation Treated with Catheter Ablation

作者:Ladapo Joseph A*; David Guy; Gunnarsson Candace L; Hao Steven C; White Sarah A; March Jamie L; Reynolds Matthew R
来源:Journal of Cardiovascular Electrophysiology, 2012, 23(1): 1-8.
DOI:10.1111/j.1540-8167.2011.02130.x

摘要

Catheter Ablation in AF Patients, Including Age 65+, Reduces Utilization. Aim: The aim was to estimate the impact of catheter ablation on short- and long-term healthcare utilization and expenditures among atrial fibrillation (AF) patients in general and Medicare populations. Methods: Data were analyzed from TheMarketScan (R) Databases. MarketScan data contain deidentified patient-level records from employer-sponsored and public health insurance plans. Multivariable regression models for utilization and expenditures were built for all patients, with subanalyses performed for patients >= 65 years. Results were compared to preablation figures and reported for 5 time groups, based on duration of available postablation follow-up: 6-12 months; 12-18 months; 18-24 months; 24-30 months; and 30-36 months. Results: A total of 3,194 patients were identified who had undergone catheter ablation for treatment of AF, had continuous enrollment in the database 6 months prior to first ablation, and had at least 1-year follow-up postablation. Compared to the 6 months prior to ablation, there were significant reductions in the number of outpatient appointments, inpatient days, and emergency room visits in the total study population and in the subset >= 65 years. There was a statistically significant (P < 0.01) decrease in total healthcare expenditures across 4 of the 5 6-month time periods, with annual savings ranging from $ 3,300 to $ 9,200. For patients >= 65 years, annual savings ranged from $3,200 to $9,200. Drug utilization also significantly declined (P < 0.01), with average annual medication savings ranging from $670 to $890, and from $740 to $880 for patients >= 65 years. Conclusion: Catheter ablation for AF reduced healthcare utilization and expenditures up to 3 years postablation. This reduction was consistent, significant, and had implications for general and Medicare populations. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1-8, January 2012)

  • 出版日期2012-1