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Cost of care distribution in atrial fibrillation patients: the COCAF study

Atrial fibrillation (AF) currently represents a major economic burden for society. Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This surve...

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Published in:The American heart journal 2004-01, Vol.147 (1), p.121-126
Main Authors: Le Heuzey, Jean-Yves, Paziaud, Olivier, Piot, Olivier, Ait Said, Mina, Copie, Xavier, Lavergne, Thomas, Guize, Louis
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description Atrial fibrillation (AF) currently represents a major economic burden for society. Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This survey, named Cost of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice. A group of 671 patients was recruited by 82 cardiologists distributed in all regions of France. The mean age of the patients was 69 years, and 64% were male. The mean follow-up was 329 ± 120 days. The costs of care were analyzed from the health care payer and the societal perspectives. During the follow-up period, 21 patients (3.13%) died and 210 (31.3%) patients were hospitalized. The number of hospitalizations and deaths was significantly higher in the group of persistent or permanent AF (PEAF) patients, as compared to paroxysmal AF (PAAF) patients. Hospitalizations were much more frequent in the PEAF group (127) than in the PAAF group (83, P < .05). Deaths were also much more frequent in the PEAF group (17) as compared to the PAAF group (4, P < .001). From the societal perspective, the first cost driver was hospitalizations (52%), followed by drugs (23%), consultations (9%), further investigations (8%), loss of work (6%), and paramedical procedures (2%). In multivariate analysis the following parameters were significantly associated with higher costs: heart failure (P < .04), coronary artery disease (P < .001), use of class III antiarrhythmic drugs (P < .002), hypertension (P < .002) and metabolic disease (P < .001). This prospective survey shows that hospitalizations represent the major cost driver in the treatment of AF patients. Outpatient care programs must be proposed to AF patients in order to avoid readmissions and to reduce the cost of treatment.
doi_str_mv 10.1016/S0002-8703(03)00524-6
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Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This survey, named Cost of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice. A group of 671 patients was recruited by 82 cardiologists distributed in all regions of France. The mean age of the patients was 69 years, and 64% were male. The mean follow-up was 329 ± 120 days. The costs of care were analyzed from the health care payer and the societal perspectives. During the follow-up period, 21 patients (3.13%) died and 210 (31.3%) patients were hospitalized. The number of hospitalizations and deaths was significantly higher in the group of persistent or permanent AF (PEAF) patients, as compared to paroxysmal AF (PAAF) patients. Hospitalizations were much more frequent in the PEAF group (127) than in the PAAF group (83, P < .05). Deaths were also much more frequent in the PEAF group (17) as compared to the PAAF group (4, P < .001). From the societal perspective, the first cost driver was hospitalizations (52%), followed by drugs (23%), consultations (9%), further investigations (8%), loss of work (6%), and paramedical procedures (2%). In multivariate analysis the following parameters were significantly associated with higher costs: heart failure (P < .04), coronary artery disease (P < .001), use of class III antiarrhythmic drugs (P < .002), hypertension (P < .002) and metabolic disease (P < .001). This prospective survey shows that hospitalizations represent the major cost driver in the treatment of AF patients. 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Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This survey, named Cost of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice. A group of 671 patients was recruited by 82 cardiologists distributed in all regions of France. The mean age of the patients was 69 years, and 64% were male. The mean follow-up was 329 ± 120 days. The costs of care were analyzed from the health care payer and the societal perspectives. During the follow-up period, 21 patients (3.13%) died and 210 (31.3%) patients were hospitalized. The number of hospitalizations and deaths was significantly higher in the group of persistent or permanent AF (PEAF) patients, as compared to paroxysmal AF (PAAF) patients. 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Very few studies have been performed to evaluate the cost of care for AF patients. This study is a large prospective survey designed to analyze the different cost drivers in the treatment of these patients. This survey, named Cost of Care in Atrial Fibrillation (COCAF), evaluated the cost of care for patients with AF treated by cardiologists in general office practice. A group of 671 patients was recruited by 82 cardiologists distributed in all regions of France. The mean age of the patients was 69 years, and 64% were male. The mean follow-up was 329 ± 120 days. The costs of care were analyzed from the health care payer and the societal perspectives. During the follow-up period, 21 patients (3.13%) died and 210 (31.3%) patients were hospitalized. The number of hospitalizations and deaths was significantly higher in the group of persistent or permanent AF (PEAF) patients, as compared to paroxysmal AF (PAAF) patients. Hospitalizations were much more frequent in the PEAF group (127) than in the PAAF group (83, P < .05). Deaths were also much more frequent in the PEAF group (17) as compared to the PAAF group (4, P < .001). From the societal perspective, the first cost driver was hospitalizations (52%), followed by drugs (23%), consultations (9%), further investigations (8%), loss of work (6%), and paramedical procedures (2%). In multivariate analysis the following parameters were significantly associated with higher costs: heart failure (P < .04), coronary artery disease (P < .001), use of class III antiarrhythmic drugs (P < .002), hypertension (P < .002) and metabolic disease (P < .001). This prospective survey shows that hospitalizations represent the major cost driver in the treatment of AF patients. Outpatient care programs must be proposed to AF patients in order to avoid readmissions and to reduce the cost of treatment.]]></abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>14691429</pmid><doi>10.1016/S0002-8703(03)00524-6</doi><tpages>6</tpages></addata></record>
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subjects Age
Age Distribution
Aged
Aged, 80 and over
Atrial Fibrillation - economics
Atrial Fibrillation - mortality
Atrial Fibrillation - therapy
Biological and medical sciences
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiology. Vascular system
Cardiovascular disease
Cause of Death
Coronary vessels
Cost of Illness
Costs
Drug Costs
Female
France - epidemiology
Health Care Costs
Health Care Surveys
Heart
Heart failure
Heart rate
Hospitalization
Hospitalization - economics
Hospitalization - statistics & numerical data
Humans
Hypertension
Industrialized nations
Insurance, Health, Reimbursement
Logistic Models
Male
Medical prognosis
Medical sciences
Metabolic disorders
Middle Aged
Multivariate Analysis
Older people
Population
Prospective Studies
Wages & salaries
title Cost of care distribution in atrial fibrillation patients: the COCAF study
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