Impact of atrial fibrillation on stroke-related healthcare costs.
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.
['Sussman|Matthew|M|', 'Menzin|Joseph|J|', 'Lin|Iris|I|', 'Kwong|Winghan J|WJ|', 'Munsell|Michael|M|', 'Friedman|Mark|M|', 'Selim|Magdy|M|']
D000368:Aged D000369:Aged, 80 and over D000925:Anticoagulants D001281:Atrial Fibrillation D002545:Brain Ischemia D017046:Cost Savings D003362:Cost-Benefit Analysis D016527:Drug Costs D005260:Female D017048:Health Care Costs D017721:Hospital Costs D006801:Humans D020300:Intracranial Hemorrhages D002546:Ischemic Attack, Transient D008297:Male D008875:Middle Aged D018803:Models, Economic D011379:Prognosis D012189:Retrospective Studies D020521:Stroke D013997:Time Factors D014481:United States
economics ischemic stroke hemorrhage transient ischemic attack outcomes research