Affiliation:
1. Boston Health Economics, Inc, Waltham, MA
2. Daiichi Sankyo, Inc, Parsippany, NJ
3. Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
Abstract
Background
Limited data exist on the economic implications of stroke among patients with atrial fibrillation (
AF
). This study assesses the impact of
AF
on healthcare costs associated with ischemic stroke (
IS
), hemorrhagic stroke (
HS
), or transient ischemic attack (
TIA
).
Methods and Results
A retrospective analysis of MarketScan claims data (2005‐2011) for
AF
patients ≥18 years old with ≥1 inpatient claim for stroke, or ≥1
ED
or inpatient claim for
TIA
as identified by
ICD
‐9‐
CM
codes who had ≥12 months continuous enrollment prior to initial stroke. Initial event‐ and stroke‐related costs 12 months post‐index were compared among patients with
AF
and without
AF
. Adjusted costs were estimated, controlling for demographics, comorbidities, anticoagulant use, and baseline resource use. Data from 23 807
AF
patients and 136 649 patients without
AF
were analyzed. Unadjusted mean cost of the index event was $20 933 for
IS
, $59 054 for
HS
, $8616 for
TIA
hospitalization, and $3395 for
TIA ED
visit. After controlling for potential confounders, adjusted mean incremental costs (index plus 12‐month post‐index) for
AF
patients were higher than those for non‐
AF
patients by: $4726, $7824, and $1890 for index
IS
,
HS
,
TIA
(identified by hospitalization), respectively, and $1700 for
TIA
(identified by
ED
) (all
P
<0.01). In multivariate regression analysis,
AF
was associated with a 20% (
IS
), 13% (
HS
), and 18% (
TIA
) increase in total stroke‐related costs.
Conclusion
Stroke‐related care for
IS
,
HS
, and
TIA
is costly, especially among individuals with
AF
. Reducing the risk of
AF
‐related stroke is important from both clinical and economic standpoints.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
35 articles.
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