The Trends of Atrial Fibrillation-Related Hospital Visit and Cost, Treatment Pattern and Mortality in Korea: 10-Year Nationwide Sample Cohort Data.
OBJECTIVE
The change of in-hospital and out-hospital treatments, and hospital costs for atrial fibrillation (AF) were not well known in rapidly aging Asian countries. This study is to examine the trends of AF management and outcomes in Korea.


METHODS
In the sample cohort from Korean National Health Insurance Data Sample Cohort (K-NHID-Sample Cohort) from 2004 through 2013, we identified patients with AF and hospital visit records using Korean Classification of Diseases, 6th Revision (KCD-6). Hospital cost, prescribed medications, radiofrequency catheter ablation (RFCA), morbidity and mortality were identified.


RESULTS
AF-related hospitalization and outpatient clinic visits increased by 2.19 and 3.06-fold, respectively. While the total cost increased from 3.6 to 11.3 billion won (p<0.001), the mean cost per patient increased from 0.68 to 0.83 million won (p<0.001). Although the mean CHA2DS2-VASc score increased from 3.5 to 4.4 in the total AF population, the proportion of patients who receive anticoagulation therapy with warfarin showed no significant change for the decade. The proportion of hospitalization for RFCA was increased (0.4% to 1.1%, p<0.001). All-cause mortality (6.7% to 5.0%), cardiovascular mortality (1.4% to 1.1%) and stroke-related death (1.3% to 0.8%) showed a modest decrease from 2004 to 2013.


CONCLUSIONS
During the last decade, AF-related hospitalization and outpatient clinic visits have increased with the increase of many other comorbidities, whereas the rate of anticoagulation did not improved. Although mortality in patients with AF showed a modest decrease from 2004 to 2013, proper anticoagulation therapy is warranted for the improvement of public health.
Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Hancheol
H
Lee
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Tae-Hoon
TH
Kim
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yong-Soo
YS
Baek
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jae-Sun
JS
Uhm
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hui-Nam
HN
Pak
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Moon-Hyoung
MH
Lee
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Boyoung
B
Joung
Atrial fibrillation; Hospital costs; National health programs