Cost of Care Distribution in Atrial Fibrillation Patients
Background: Atrial fibrillation (AF) currently represents a major economic burden for society. Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This survey, named Cost of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice.
Methods: A group of 671 patients was recruited by 82 cardiologists distributed in all regions of France. The mean age of the patients was 69 years, and 64% were male. The mean follow-up was 329 ± 120 days. The costs of care were analyzed from the health care payer and the societal perspectives.
Results: During the follow-up period, 21 patients (3.13%) died and 210 (31.3%) patients were hospitalized. The number of hospitalizations and deaths was significantly higher in the group of persistent or permanent AF (PEAF) patients, as compared to paroxysmal AF (PAAF) patients. Hospitalizations were much more frequent in the PEAF group (127) than in the PAAF group (83, P < .05). Deaths were also much more frequent in the PEAF group (17) as compared to the PAAF group (4, P < .001). From the societal perspective, the first cost driver was hospitalizations (52%), followed by drugs (23%), consultations (9%), further investigations (8%), loss of work (6%), and paramedical procedures (2%). In multivariate analysis the following parameters were significantly associated with higher costs: heart failure (P < .04), coronary artery disease (P < .001), use of class III antiarrhythmic drugs (P < .002), hypertension (P < .002) and metabolic disease (P < .001).
Conclusions: This prospective survey shows that hospitalizations represent the major cost driver in the treatment of AF patients. Outpatient care programs must be proposed to AF patients in order to avoid readmissions and to reduce the cost of treatment.
Atrial fibrillation (AF) is the most common arrhythmia. Its prevalence dramatically increases with age. It has been clearly demonstrated that AF impairs life expectancy. AF is frequently associated with underlying cardiovascular or metabolic disorders such as heart failure, coronary artery disease, hypertension, valvular disease, and diabetes mellitus. The prevalence of AF is increasing because the population in many developed countries is aging and because survival of patients with underlying diseases associated with AF is improving. The rising prevalence of AF may also be leading to an increasing public health burden. AF now represents a major economic burden for society. Very few studies have been performed to evaluate the cost of care for AF patients. We performed a large prospective survey in order to analyze the different cost drivers in the treatment of AF patients. This survey, named Cost Of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice.
Background: Atrial fibrillation (AF) currently represents a major economic burden for society. Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This survey, named Cost of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice.
Methods: A group of 671 patients was recruited by 82 cardiologists distributed in all regions of France. The mean age of the patients was 69 years, and 64% were male. The mean follow-up was 329 ± 120 days. The costs of care were analyzed from the health care payer and the societal perspectives.
Results: During the follow-up period, 21 patients (3.13%) died and 210 (31.3%) patients were hospitalized. The number of hospitalizations and deaths was significantly higher in the group of persistent or permanent AF (PEAF) patients, as compared to paroxysmal AF (PAAF) patients. Hospitalizations were much more frequent in the PEAF group (127) than in the PAAF group (83, P < .05). Deaths were also much more frequent in the PEAF group (17) as compared to the PAAF group (4, P < .001). From the societal perspective, the first cost driver was hospitalizations (52%), followed by drugs (23%), consultations (9%), further investigations (8%), loss of work (6%), and paramedical procedures (2%). In multivariate analysis the following parameters were significantly associated with higher costs: heart failure (P < .04), coronary artery disease (P < .001), use of class III antiarrhythmic drugs (P < .002), hypertension (P < .002) and metabolic disease (P < .001).
Conclusions: This prospective survey shows that hospitalizations represent the major cost driver in the treatment of AF patients. Outpatient care programs must be proposed to AF patients in order to avoid readmissions and to reduce the cost of treatment.
Atrial fibrillation (AF) is the most common arrhythmia. Its prevalence dramatically increases with age. It has been clearly demonstrated that AF impairs life expectancy. AF is frequently associated with underlying cardiovascular or metabolic disorders such as heart failure, coronary artery disease, hypertension, valvular disease, and diabetes mellitus. The prevalence of AF is increasing because the population in many developed countries is aging and because survival of patients with underlying diseases associated with AF is improving. The rising prevalence of AF may also be leading to an increasing public health burden. AF now represents a major economic burden for society. Very few studies have been performed to evaluate the cost of care for AF patients. We performed a large prospective survey in order to analyze the different cost drivers in the treatment of AF patients. This survey, named Cost Of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice.