Assessing the direct costs of treating nonvalvular atrial fibrillation in the United States. Coyne, K. S., Paramore, C., Grandy, S., Mercader, M., Reynolds, M., & Zimetbaum, P. Value Health, 9(5):348--356, 2006.
abstract   bibtex   
afib OBJECTIVE: To determine the health-care resource use and costs attributable to treating atrial fibrillation (AF) in the United States. METHODS: Retrospective analyses of three federally funded US databases (2001 data): 1) hospital inpatient stays (the Healthcare Cost and Utilization Project [HCUP]); 2) physician office visits (the National Ambulatory Medical Care Survey [NAMCS]); and 3) emergency department (ED) and hospital outpatient department visits (OPD) (the National Hospital Ambulatory Medical Care Survey [NHAMCS]). Identification of AF medical encounters was based on occurrence of AF-specific International Classification of Diseases (9th Edition)--Clinical Modification (ICD-9-CM) diagnosis code 427.31 (principal discharge diagnosis for inpatient setting; any diagnosis field for other settings). For the 10 most common principal discharge diagnoses in the inpatient setting, case-control comparison analyses were performed to estimate annual incremental costs of AF as a comorbid discharge diagnosis for hospital stays. Regression models were used to assess the impact of AF on hospitalization costs. Costs were estimated in year 2005 US dollars. RESULTS: Approximately 350,000 hospitalizations, 5.0 million office visits, 276,000 ED visits, and 234,000 OPD were attributable to AF annually within the United States. Total annual costs for treatment of AF were estimated at \$6.65 billion, including \$2.93 billion (44%) for hospitalizations with a principal discharge diagnosis of AF, \$1.95 billion (29%) for the incremental inpatient cost of AF as a comorbid diagnosis, \$1.53 billion (23%) for outpatient treatment of AF, and \$235 million (4%) for prescription drugs. In all regressions, AF was a significant contributor to hospital cost. CONCLUSIONS: Treatment of AF represents a significant health-care burden with the costs of treating AF in the inpatient setting outweighing the costs of treating AF in the office, emergency room or hospital outpatient settings. Further research is needed to fully capture the costs of treating AF.
@Article{RSM:Coy2006,
  author =       "K. S. Coyne and C. Paramore and S. Grandy and M.
                 Mercader and M. Reynolds and P. Zimetbaum",
  title =        "Assessing the direct costs of treating nonvalvular
                 atrial fibrillation in the {United States}",
  journal =      "Value Health",
  volume =       "9",
  number =       "5",
  pages =        "348--356",
  abstract =     "afib OBJECTIVE: To determine the health-care resource use
                 and costs attributable to treating atrial fibrillation
                 (AF) in the United States. METHODS: Retrospective
                 analyses of three federally funded US databases (2001
                 data): 1) hospital inpatient stays (the Healthcare Cost
                 and Utilization Project [HCUP]); 2) physician office
                 visits (the National Ambulatory Medical Care Survey
                 [NAMCS]); and 3) emergency department (ED) and hospital
                 outpatient department visits (OPD) (the National
                 Hospital Ambulatory Medical Care Survey [NHAMCS]).
                 Identification of AF medical encounters was based on
                 occurrence of AF-specific International Classification
                 of Diseases (9th Edition)--Clinical Modification
                 (ICD-9-CM) diagnosis code 427.31 (principal discharge
                 diagnosis for inpatient setting; any diagnosis field
                 for other settings). For the 10 most common principal
                 discharge diagnoses in the inpatient setting,
                 case-control comparison analyses were performed to
                 estimate annual incremental costs of AF as a comorbid
                 discharge diagnosis for hospital stays. Regression
                 models were used to assess the impact of AF on
                 hospitalization costs. Costs were estimated in year
                 2005 US dollars. RESULTS: Approximately 350,000
                 hospitalizations, 5.0 million office visits, 276,000 ED
                 visits, and 234,000 OPD were attributable to AF
                 annually within the United States. Total annual costs
                 for treatment of AF were estimated at \$6.65 billion,
                 including \$2.93 billion (44\%) for hospitalizations
                 with a principal discharge diagnosis of AF, \$1.95
                 billion (29\%) for the incremental inpatient cost of AF
                 as a comorbid diagnosis, \$1.53 billion (23\%) for
                 outpatient treatment of AF, and \$235 million (4\%) for
                 prescription drugs. In all regressions, AF was a
                 significant contributor to hospital cost. CONCLUSIONS:
                 Treatment of AF represents a significant health-care
                 burden with the costs of treating AF in the inpatient
                 setting outweighing the costs of treating AF in the
                 office, emergency room or hospital outpatient settings.
                 Further research is needed to fully capture the costs
                 of treating AF.",
  year =         "2006",
}
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