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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
The burden of atrial fibrillation on the hospital sector in Canada
Daria J O'Reilly1, Robert B Hopkins, Jeff S Healey
1Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada. oreilld@mcmaster.ca
Insights
Atrial fibrillation (AF) significantly burdens Canadian hospitals, costing $815 million annually. Most costs stem from AF-related hospitalizations and comorbidities, not direct AF treatments.
Area of Science:
- Health Economics
- Cardiology
- Public Health
Background:
- Atrial fibrillation (AF) is a prevalent condition necessitating frequent acute hospital care.
- The economic impact of AF on Canadian hospital care has not been previously quantified.
Purpose of the Study:
- To estimate the total cost of hospital-based care attributable to atrial fibrillation in Canada.
Main Methods:
- Utilized national administrative databases from 2007-2008, including hospital admissions, day surgeries, and ambulatory care.
- Calculated costs by applying average cost per weighted case and resource intensity weights, adding fees for procedures and interventions.
- Included records with AF as primary diagnosis, atrial flutter, or AF with comorbidities.
Main Results:
- In 2007-2008, AF accounted for $815 million in Canadian hospital costs (2010 CAD).
- Hospitalizations represented the largest cost component ($710 million), with comorbidities driving 69% ($558 million) of acute care expenses.
- Emergency department visits and same-day surgical procedures added $73 million and $32 million, respectively.
Conclusions:
- Atrial fibrillation imposes a substantial financial burden on Canada's acute care hospital sector.
- The majority of AF-related hospital costs are associated with managing AF's consequences and comorbidities.
- Direct treatment costs for AF constitute a relatively small portion of the overall expenditure.
Background:
Atrial fibrillation (AF) is a common disease that frequently requires acute hospital care; however, the cost of hospital care in Canada has not been reported. The purpose of this study was to estimate the cost of AF related to hospital-based care in Canada.
Methods:
Analyses were conducted with 2 national administrative databases for the fiscal year 2007-2008. Databases included information for hospital admissions, day operations, and ambulatory care. Records with a most responsible diagnosis of AF, atrial flutter, or a diagnosis related to AF with a concomitant comorbidity of AF were included. Hospital costs were estimated, in 2010 Canadian dollars, by applying an average cost per weighted case to the resource intensity weight for each admission or visit and then adding the separate billable fee for admissions, surgical procedures, and interventions.
Results:
In 2007-2008, the number of acute care admissions with AF as the most responsible diagnosis was 22,823, same-day surgical procedures was 5707, and emergency department visits was 58,066. The hospital costs attributable to AF were $815 million in 2010 Canadian dollars: $710 million for hospitalizations; $32 million for same-day surgical procedures; and $73 million for emergency department visits. Most of the acute care costs were for hospitalizations when AF was listed as a comorbidity ($558 million, or 69%).
Conclusion:
AF results in a substantial cost burden to the acute care hospital sector. Current hospital costs in AF patients are driven by the consequences of AF, while the costs for specific treatments for AF are relatively low.
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