Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK

• Published in: Heart (British Cardiac Society) 2004-03, Vol.90 (3), p.286-292
• Main Authors: Stewart, S, Murphy, N, Walker, A, McGuire, A, McMurray, J J V
• Format: Article
• Language: English
• Subjects: Age; Aged; Ambulatory Care - economics; Anticoagulants; atrial fibrillation; Atrial Fibrillation - economics; Atrial Fibrillation - epidemiology; Biological and medical sciences; Cardiac arrhythmia; Cardiac dysrhythmias; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Medicine; Community Health Services - economics; cost evaluation; Cost of Illness; Cost-Benefit Analysis; Costs; Drug Prescriptions - economics; Family Practice - economics; Fatalities; Female; Health care expenditures; Health Expenditures; Heart; Heart failure; Hospital Costs; hospitalisation; Hospitalization; Hospitalization - economics; Hospitals; Humans; Long term health care; Long-Term Care - economics; Male; Medical sciences; Medical statistics; Middle Aged; morbidity; Nursing homes; Nursing Homes - economics; Outpatient care facilities; Patients; Practice research; Prescriptions; Program Evaluation; Referral and Consultation - economics; United Kingdom
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2002.008748

Objective: To evaluate the cost of atrial fibrillation (AF) to health and social services in the UK in 1995 and, based on epidemiological trends, to project this estimate to 2000. Design, setting, and main outcome measures: Contemporary estimates of health care activity related to AF were applied to the whole population of the UK on an age and sex specific basis for the year 1995. The activities considered (and costs calculated) were hospital admissions, outpatient consultations, general practice consultations, and drug treatment (including the cost of monitoring anticoagulant treatment). By adjusting for the progressive aging of the British population and related increases in hospital admissions, the cost of AF was also projected to the year 2000. Results: There were 534 000 people with AF in the UK during 1995. The “direct” cost of health care for these patients was £244 million (~€350 million) or 0.62% of total National Health Service (NHS) expenditure. Hospitalisations and drug prescriptions accounted for 50% and 20% of this expenditure, respectively. Long term nursing home care after hospital admission cost an additional £46.4 million (~€66 million). The direct cost of AF rose to £459 million (~€655 million) in 2000, equivalent to 0.97% of total NHS expenditure based on 1995 figures. Nursing home costs rose to £111 million (~€160 million). Conclusions: AF is an extremely costly public health problem.