Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls
Aims Atrial fibrillation (AF) costs are expected to be substantial, but cost comparisons with the general population are scarce. Using data from the prospective Swiss-AF cohort study and population-based controls, we estimated the impact of AF on direct healthcare costs from the Swiss statutory heal...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/9/e072080.full |
| _version_ | 1797668655004123136 |
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| author | Stefanie Aeschbacher David Conen Stefan Osswald Andreas Mueller Tobias Reichlin Christian Sticherling Matthias Schwenkglenks Eva Blozik Beat Brüngger Nicolas Rodondi Michael Kuehne Giorgio Moschovitis Jürg-Hans Beer Giulio Conte Anne Springer Miquel Serra-Burriel Leo Bonati Manuel Blum Thomas Szucs Helena Aebersold Stefan Felder Rebecca E Paladini Annina Stauber Fabienne Foster-Witassek Carola Huber |
| author_facet | Stefanie Aeschbacher David Conen Stefan Osswald Andreas Mueller Tobias Reichlin Christian Sticherling Matthias Schwenkglenks Eva Blozik Beat Brüngger Nicolas Rodondi Michael Kuehne Giorgio Moschovitis Jürg-Hans Beer Giulio Conte Anne Springer Miquel Serra-Burriel Leo Bonati Manuel Blum Thomas Szucs Helena Aebersold Stefan Felder Rebecca E Paladini Annina Stauber Fabienne Foster-Witassek Carola Huber |
| author_sort | Stefanie Aeschbacher |
| collection | DOAJ |
| description | Aims Atrial fibrillation (AF) costs are expected to be substantial, but cost comparisons with the general population are scarce. Using data from the prospective Swiss-AF cohort study and population-based controls, we estimated the impact of AF on direct healthcare costs from the Swiss statutory health insurance perspective.Methods Swiss-AF patients, enrolled from 2014 to 2017, had documented, prevalent AF. We analysed 5 years of follow-up, where clinical data, and health insurance claims in 42% of the patients were collected on a yearly basis. Controls from a health insurance claims database were matched for demographics and region. The cost impact of AF was estimated using five different methods: (1) ordinary least square regression (OLS), (2) OLS-based two-part modelling, (3) generalised linear model-based two-part modelling, (4) 1:1 nearest neighbour propensity score matching and (5) a cost adjudication algorithm using Swiss-AF data non-comparatively and considering clinical data. Cost of illness at the Swiss national level was modelled using obtained cost estimates, prevalence from the Global Burden of Disease Project, and Swiss population data.Results The 1024 Swiss-AF patients with available claims data were compared with 16 556 controls without known AF. AF patients accrued CHF5600 (EUR5091) of AF-related direct healthcare costs per year, in addition to non-AF-related healthcare costs of CHF11100 (EUR10 091) per year accrued by AF patients and controls. All five methods yielded comparable results. AF-related costs at the national level were estimated to amount to 1% of Swiss healthcare expenditure.Conclusions We robustly found direct medical costs of AF patients were 50% higher than those of population-based controls. Such information on the incremental cost burden of AF may support healthcare capacity planning. |
| first_indexed | 2024-03-11T20:31:33Z |
| format | Article |
| id | doaj.art-a881604613cd4f0bba85847f90fcada7 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T20:31:33Z |
| publishDate | 2023-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-a881604613cd4f0bba85847f90fcada72023-10-02T08:20:07ZengBMJ Publishing GroupBMJ Open2044-60552023-09-0113910.1136/bmjopen-2023-072080Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controlsStefanie Aeschbacher0David Conen1Stefan Osswald2Andreas Mueller3Tobias Reichlin4Christian Sticherling5Matthias Schwenkglenks6Eva Blozik7Beat Brüngger8Nicolas Rodondi9Michael Kuehne10Giorgio Moschovitis11Jürg-Hans Beer12Giulio Conte13Anne Springer14Miquel Serra-Burriel15Leo Bonati16Manuel Blum17Thomas Szucs18Helena Aebersold19Stefan Felder20Rebecca E Paladini21Annina Stauber22Fabienne Foster-Witassek23Carola Huber24Cardiovascular Research Institute Basel, University Hospital Basel, Basel, SwitzerlandPopulation Health Research Institute, McMaster University, Hamilton, Ontario, CanadaDepartment of Medicine, Cardiology Division, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiology, Triemli Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, Inselspital, University Hospital Bern, Bern, SwitzerlandDepartment of Medicine, Cardiology Division, University Hospital Basel, Basel, SwitzerlandInstitute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, SwitzerlandInstitute of Primary Care, University of Zurich, Zurich, SwitzerlandDepartment of Health Sciences, Helsana Group, Zurich, SwitzerlandInstitute of Primary Health Care (BIHAM), University of Bern, Bern, SwitzerlandDepartment of Medicine, Cardiology Division, University Hospital Basel, Basel, SwitzerlandDivision of Cardiology, Ente Ospedaliero Cantonale (EOC), Instituto Cardiocentro Ticino, Ospedale Regionale di Lugano, Lugano, SwitzerlandDepartment of Medicine, Baden Cantonal Hospital, Baden, SwitzerlandDivision of Cardiology, Cardiocentro Ticino (CCT), Lugano, SwitzerlandDepartment of Medicine, Cardiology Division, University Hospital Basel, Basel, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, SwitzerlandDepartment of Neurology, University Hospital Basel, Basel, SwitzerlandInstitute of Primary Health Care (BIHAM), University of Bern, Bern, SwitzerlandInstitute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, SwitzerlandFaculty of Business and Economics, University of Basel, Basel, SwitzerlandDepartment of Medicine, Cardiology Division, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiology, Triemli Hospital Zurich, Zurich, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, SwitzerlandDepartment of Health Sciences, Helsana Group, Zurich, SwitzerlandAims Atrial fibrillation (AF) costs are expected to be substantial, but cost comparisons with the general population are scarce. Using data from the prospective Swiss-AF cohort study and population-based controls, we estimated the impact of AF on direct healthcare costs from the Swiss statutory health insurance perspective.Methods Swiss-AF patients, enrolled from 2014 to 2017, had documented, prevalent AF. We analysed 5 years of follow-up, where clinical data, and health insurance claims in 42% of the patients were collected on a yearly basis. Controls from a health insurance claims database were matched for demographics and region. The cost impact of AF was estimated using five different methods: (1) ordinary least square regression (OLS), (2) OLS-based two-part modelling, (3) generalised linear model-based two-part modelling, (4) 1:1 nearest neighbour propensity score matching and (5) a cost adjudication algorithm using Swiss-AF data non-comparatively and considering clinical data. Cost of illness at the Swiss national level was modelled using obtained cost estimates, prevalence from the Global Burden of Disease Project, and Swiss population data.Results The 1024 Swiss-AF patients with available claims data were compared with 16 556 controls without known AF. AF patients accrued CHF5600 (EUR5091) of AF-related direct healthcare costs per year, in addition to non-AF-related healthcare costs of CHF11100 (EUR10 091) per year accrued by AF patients and controls. All five methods yielded comparable results. AF-related costs at the national level were estimated to amount to 1% of Swiss healthcare expenditure.Conclusions We robustly found direct medical costs of AF patients were 50% higher than those of population-based controls. Such information on the incremental cost burden of AF may support healthcare capacity planning.https://bmjopen.bmj.com/content/13/9/e072080.full |
| spellingShingle | Stefanie Aeschbacher David Conen Stefan Osswald Andreas Mueller Tobias Reichlin Christian Sticherling Matthias Schwenkglenks Eva Blozik Beat Brüngger Nicolas Rodondi Michael Kuehne Giorgio Moschovitis Jürg-Hans Beer Giulio Conte Anne Springer Miquel Serra-Burriel Leo Bonati Manuel Blum Thomas Szucs Helena Aebersold Stefan Felder Rebecca E Paladini Annina Stauber Fabienne Foster-Witassek Carola Huber Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls BMJ Open |
| title | Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls |
| title_full | Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls |
| title_fullStr | Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls |
| title_full_unstemmed | Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls |
| title_short | Estimating the cost impact of atrial fibrillation using a prospective cohort study and population-based controls |
| title_sort | estimating the cost impact of atrial fibrillation using a prospective cohort study and population based controls |
| url | https://bmjopen.bmj.com/content/13/9/e072080.full |
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