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Economic Burden of Inpatient Care for Mitral Regurgitation in Maryland
Radoslav Zinoviev1, Rani K Hasan2, James S Gammie3
1Division of Cardiology University of California Los Angeles CA.
Background:
Mitral regurgitation (MR) is the most common valvular disease in the United States and increases the risk of death and hospitalization. The economic burden of MR in the United States is not known.
Methods And Results:
We analyzed inpatient hospitalization data from the 1 221 173 Maryland residents who had any in-state admissions from October 1, 2015, to September 30, 2019. We assessed the total charges for patients without MR and for patients with MR who underwent medical management, transcatheter mitral valve repair or replacement, or surgical mitral valve repair or replacement. During the study period, 26 076 inpatients had a diagnosis of MR. Compared with patients without MR, these patients had more comorbidities and higher inpatient mortality. Patients with medically managed MR incurred average total charges of $23 575 per year; MR was associated with $10 559 more in charges per year and an incremental 3.1 more inpatient days per year as compared with patients without MR. Both surgical mitral valve repair or replacement and transcatheter mitral valve repair or replacement were associated with higher charges as compared with medical management during the year of intervention ($47 943 for surgical mitral valve repair or replacement and $63 108 for transcatheter mitral valve repair or replacement). Annual charges for both groups were significantly lower as compared with medical management in the second and third years postintervention.
Conclusions:
MR is associated with higher mortality and inpatient charges. Patients who undergo surgical or transcatheter intervention incur lower charges compared with medically managed MR patients in the years after the procedure.
Insights
Mitral regurgitation (MR) increases hospital costs and mortality. Interventions like valve repair or replacement lead to lower annual charges in subsequent years compared to medical management alone.
Area of Science:
- Cardiology
- Health Economics
Background:
- Mitral regurgitation (MR) is a prevalent valvular heart disease in the US, associated with increased mortality and hospitalization risks.
- The economic impact of MR in the United States remains largely unquantified.
Purpose of the Study:
- To determine the economic burden of mitral regurgitation (MR) in the United States.
- To compare inpatient charges associated with different management strategies for MR.
Main Methods:
- Analysis of inpatient hospitalization data for Maryland residents from October 2015 to September 2019.
- Assessment of total charges for patients with and without MR, stratified by management: medical, transcatheter intervention, or surgical intervention.
Main Results:
- MR patients (26,076) had more comorbidities and higher inpatient mortality than non-MR patients.
- Medically managed MR patients incurred average annual charges of $23,575, with MR adding $10,559 and 3.1 inpatient days annually.
- Surgical or transcatheter interventions had higher initial charges ($47,943 and $63,108, respectively) but resulted in lower annual charges in subsequent years compared to medical management.
Conclusions:
- Mitral regurgitation is linked to increased inpatient costs and mortality.
- Surgical and transcatheter interventions for MR are associated with reduced long-term healthcare charges compared to medical management alone.
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