Direct treatment cost of atrial fibrillation in the elderly American population: a Medicare perspective.
OBJECTIVE
Although atrial fibrillation (AF) is the most commonly sustained arrhythmia in adults, few studies have examined the direct treatment cost of AF.


METHODS
A Medicare database of a 5% random national sample of all beneficiaries was used to identify patients diagnosed with AF in 2003 and to follow them for 1 year after diagnosis. These patients were matched on a 1:1 basis by age, gender and race. The incremental cost of treating AF was calculated with multivariate regression models adjusting for covariates.


RESULTS
In total, 55,260 subjects developed new AF, of which 69% were >or=75 years old, 54% were female and 91% were White. The adjusted mean incremental treatment cost of AF was $14,199 (95% confidence interval $13,201-15,001; p<0.01). Some of this cost was attributable to the incidence of stroke and heart failure at the 1-year post-AF diagnosis. A significantly higher proportion of AF patients experienced stroke (23.1 vs. 13.3%; p<0.01) and heart failure (36.7 vs. 10.4%; p<0.01) compared with Medicare beneficiaries without AF.


CONCLUSIONS
Mean incremental direct treatment costs for Medicare beneficiaries with AF were higher than previously reported. Interventions that can reduce the incidence of AF and its complications may also reduce the national economic impact of AF.
Lee
Won Chan
WC
HERQuLES, Abt Associates Inc., Bethesda, MD 20814-3343, USA. wonchan_lee@abtassoc.com
Lamas
Gervasio A
GA
Balu
Sanjeev
S
Spalding
James
J
Wang
Qin
Q
Pashos
Chris L
CL
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D006278:Medicare; D012044:Regression Analysis; D012189:Retrospective Studies; D014481:United States