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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Cost of illness of atrial fibrillation: a nationwide study of societal impact

Authors: Søren Paaske Johnsen, Lene Worsaae Dalby, Tomas Täckström, Jens Olsen, Anina Fraschke

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

The prevalence of atrial fibrillation is increasing rapidly; however, to date, population-based data are lacking on the attributable cost of illness of atrial fibrillation from a societal perspective, including both direct and indirect costs.

Methods

The study was an incidence-based cost-of-illness study based on national registries covering the entire population of Denmark. We identified all patients with a first-time hospital diagnosis of atrial fibrillation between 2001 and 2012. For every atrial fibrillation patient, we identified three age- and sex-matched controls from the general population. Both the total and the attributable costs of atrial fibrillation were estimated based on individual level information on hospital care (in- and out-patient contacts), primary sector care, use of prescription drugs and productivity loss.

Results

Average 3-year societal costs per patient attributable to atrial fibrillation were estimated to be €20,403–26,544 during the study period. The costs were highest during the first year after diagnosis of atrial fibrillation. Admission costs constituted the largest cost component, whereas primary sector costs and medicine costs only constituted minor components. The attributable costs were more than two-fold higher among patients experiencing a stroke. The total 3-year cost attributable to atrial fibrillation in Denmark was estimated to be €219–295 million.

Conclusions

The societal costs attributable to atrial fibrillation are significant. Reducing the need for hospitalizations, in particular from stroke, is a key factor in controlling the costs.
Literature
1.
2.
3.
go back to reference Svennberg E, Engdahl J, Al-Khalili F, et al. Mass screening for untreated Atrial fibrillation: the STROKESTOP study. Circulation. 2015;131:2176–84.CrossRefPubMed Svennberg E, Engdahl J, Al-Khalili F, et al. Mass screening for untreated Atrial fibrillation: the STROKESTOP study. Circulation. 2015;131:2176–84.CrossRefPubMed
4.
go back to reference Colilla S, Crow A, Petkun W, et al. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. 2013;112:1142–7.CrossRefPubMed Colilla S, Crow A, Petkun W, et al. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. 2013;112:1142–7.CrossRefPubMed
5.
go back to reference European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the Management of Atrial Fibrillation: the task force for the management of Atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31:2369–429.CrossRef European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the Management of Atrial Fibrillation: the task force for the management of Atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31:2369–429.CrossRef
6.
go back to reference Wolowacz SE, Samuel M, Brennan VK, Jasso-Mosqueda JG, Van Gelder IC. The cost of illness of atrial fibrillation: a systematic review of the recent literature. Europace. 2011;13:1375–85.CrossRefPubMed Wolowacz SE, Samuel M, Brennan VK, Jasso-Mosqueda JG, Van Gelder IC. The cost of illness of atrial fibrillation: a systematic review of the recent literature. Europace. 2011;13:1375–85.CrossRefPubMed
7.
go back to reference Ericson L, Bergfeldt L, Björholt I. Atrial fibrillation: the cost of illness in Sweden. Eur J Health Econ. 2011;12:479–87.CrossRefPubMed Ericson L, Bergfeldt L, Björholt I. Atrial fibrillation: the cost of illness in Sweden. Eur J Health Econ. 2011;12:479–87.CrossRefPubMed
8.
go back to reference Jönsson L, Eliasson A, Kindblom J, Almgren O, Edvardsson N. Cost of illness and drivers of cost in atrial fibrillation in Sweden and Germany. Appl Health Econ Health Policy. 2010;8:317–25.CrossRefPubMed Jönsson L, Eliasson A, Kindblom J, Almgren O, Edvardsson N. Cost of illness and drivers of cost in atrial fibrillation in Sweden and Germany. Appl Health Econ Health Policy. 2010;8:317–25.CrossRefPubMed
9.
go back to reference Jeantet M, Losay J, Cassinat G, et al. Paroxysmal atrial fibrillation in community medicine: management intentions and cost estimates. Arch Mal Coeur Vaiss. 2001;94:1103–9.PubMed Jeantet M, Losay J, Cassinat G, et al. Paroxysmal atrial fibrillation in community medicine: management intentions and cost estimates. Arch Mal Coeur Vaiss. 2001;94:1103–9.PubMed
10.
go back to reference Coyne KS, Paramore C, Grandy S, et al. Assessing the direct costs of treating nonvalvular atrial fibrillation in the United States. Value Health. 2006;9:348–56.CrossRefPubMed Coyne KS, Paramore C, Grandy S, et al. Assessing the direct costs of treating nonvalvular atrial fibrillation in the United States. Value Health. 2006;9:348–56.CrossRefPubMed
11.
go back to reference Stewart S, Murphy NF, Walker A, McGuire A, McMurray JJ. Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart. 2004;90:286–92.CrossRefPubMedPubMedCentral Stewart S, Murphy NF, Walker A, McGuire A, McMurray JJ. Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart. 2004;90:286–92.CrossRefPubMedPubMedCentral
12.
go back to reference Schmidt M, Schmidt SA, Sandegaard JL, et al. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol. 2015;7:449–90.CrossRefPubMedPubMedCentral Schmidt M, Schmidt SA, Sandegaard JL, et al. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol. 2015;7:449–90.CrossRefPubMedPubMedCentral
13.
14.
go back to reference Andersen JS, Olivarius Nde F, Krasnik A. The Danish National Health Service Registry. Scand J Public Health. 2011;39(7 Suppl):34–7.CrossRefPubMed Andersen JS, Olivarius Nde F, Krasnik A. The Danish National Health Service Registry. Scand J Public Health. 2011;39(7 Suppl):34–7.CrossRefPubMed
15.
go back to reference Kildemoes HW, Sørensen HT, Hallas J. The Danish National Prescription Registry. Scand J Public Health. 2011;39(7 Suppl):38–41.CrossRefPubMed Kildemoes HW, Sørensen HT, Hallas J. The Danish National Prescription Registry. Scand J Public Health. 2011;39(7 Suppl):38–41.CrossRefPubMed
16.
go back to reference Hjollund NH, Larsen FB, Andersen JH. Registry-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey. Scand J Public Health. 2007;35:497–502.CrossRefPubMed Hjollund NH, Larsen FB, Andersen JH. Registry-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey. Scand J Public Health. 2007;35:497–502.CrossRefPubMed
17.
go back to reference Jakobsen M, Kolodziejczyk C, Fredslund EK, Poulsen PB, Dybro L, Johnsen SP. Costs of major intracranial, gastrointestinal and other bleeding events in patients with atrial fibrillation – a nationwide cohort study. BMC Health Serv Res. 2017;17:398.CrossRefPubMedPubMedCentral Jakobsen M, Kolodziejczyk C, Fredslund EK, Poulsen PB, Dybro L, Johnsen SP. Costs of major intracranial, gastrointestinal and other bleeding events in patients with atrial fibrillation – a nationwide cohort study. BMC Health Serv Res. 2017;17:398.CrossRefPubMedPubMedCentral
18.
go back to reference Jakobsen M, Kolodziejczyk C, Fredslund EK, Poulsen PB, Dybro L, Johnsen SP. Societal costs of first-incident ischemic stroke in patients with Atrial fibrillation-a Danish Nationwide registry study. Value Health. 2016;19:413–8.CrossRefPubMed Jakobsen M, Kolodziejczyk C, Fredslund EK, Poulsen PB, Dybro L, Johnsen SP. Societal costs of first-incident ischemic stroke in patients with Atrial fibrillation-a Danish Nationwide registry study. Value Health. 2016;19:413–8.CrossRefPubMed
19.
go back to reference Jorgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS. Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke. 1996;27:1765–9.CrossRefPubMed Jorgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS. Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke. 1996;27:1765–9.CrossRefPubMed
20.
go back to reference Thygesen SK, Frost L, Eagle KA, Johnsen SP. Atrial fibrillation in patients with ischemic stroke: a population-based study. Clin Epidemiol. 2009;1:55–65.CrossRefPubMedPubMedCentral Thygesen SK, Frost L, Eagle KA, Johnsen SP. Atrial fibrillation in patients with ischemic stroke: a population-based study. Clin Epidemiol. 2009;1:55–65.CrossRefPubMedPubMedCentral
21.
go back to reference Rix TA, Riahi S, Overvad K, et al. Validity of the diagnoses atrial fibrillation and atrial flutter in a Danish patient registry. Scand Cardiovasc J. 2012;46:149–53.CrossRefPubMed Rix TA, Riahi S, Overvad K, et al. Validity of the diagnoses atrial fibrillation and atrial flutter in a Danish patient registry. Scand Cardiovasc J. 2012;46:149–53.CrossRefPubMed
22.
go back to reference Wildenschild C, Mehnert F, Thomsen RW, et al. Registration of acute stroke: validity in the Danish stroke registry and the Danish National Registry of patients. Clin Epidemiol. 2013;6:27–36.CrossRefPubMedPubMedCentral Wildenschild C, Mehnert F, Thomsen RW, et al. Registration of acute stroke: validity in the Danish stroke registry and the Danish National Registry of patients. Clin Epidemiol. 2013;6:27–36.CrossRefPubMedPubMedCentral
Metadata
Title
Cost of illness of atrial fibrillation: a nationwide study of societal impact
Authors
Søren Paaske Johnsen
Lene Worsaae Dalby
Tomas Täckström
Jens Olsen
Anina Fraschke
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2652-y

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