Trends in health care expenditures and incremental health care cost in adults with atrial fibrillation in the United States

Abstract

Background

Atrial fibrillation (AF) is associated with increased health care costs; however, comprehensive data on the financial burden of AF remain limited.

Objective

The purpose of this study was to delineate health care expenditures among patients with AF.

Methods

We used the longitudinal panels from the Medical Expenditure Panel Survey covering 2016–2019 to estimate health care expenditures associated with AF. We identified individuals 18 years and older with AF in the first year of each panel (2016–2018) by using the International Classification of Disease, Tenth Revision codes. Covariates included sociodemographic characteristics and comorbidities. Health care expenditures were derived from the second year of each panel (2017–2019) to reflect the cost of having the condition for an entire year. Adjusted mean annual costs were calculated, including total health care expenditure, hospital inpatient, emergency department visits, office-based visits, outpatient visits, home health visits, prescribed medicines, and other expenses. Adjusted models were used to estimate the mean annual incremental total health care cost associated with AF.

Results

The weighted study population included 3,080,055 adults with AF (382 respondents; mean age 71.5; 89.9% white). The adjusted annual total health care cost in adults with AF totaled $14,083 (95% confidence interval $10,887–$17,279) compared with $8771 (95% confidence interval $8106–$9436) for those without AF. The primary drivers of cost over time were hospital inpatient care, office-based visits, and prescribed medications. The annual incremental total health care cost associated with AF was $5312 per adult (in 2019 U.S. dollars).

Conclusion

Adults with AF in the United States face a higher financial burden across various health care services than do those without the condition, with consistently increasing expenses in inpatient care and prescribed medicines. Further research is needed to identify the independent contribution of AF to these costs.