title: Healthcare utilization and expenditures in patients with atrial fibrillation treated with catheter ablation.
abstract: OBJECTIVE
  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 The MarketScan(®) 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. jladapo@post.harvard.edu
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ladapo
authors.forename: Guy
authors.initials: G
authors.lastname: David
authors.forename: Candace L
authors.initials: CL
authors.lastname: Gunnarsson
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hao
authors.forename: Sarah A
authors.initials: SA
authors.lastname: White
authors.forename: Jamie L
authors.initials: JL
authors.lastname: March
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D001281:Atrial Fibrillation / Q000191:economics* / Q000601:surgery*; D017115:Catheter Ablation / Q000191:economics* / Q000706:statistics & numerical data*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States