Ciminata, G., Geue, C. , Langhorne, P. and Wu, O. (2020) A two-part model to estimate inpatient, outpatient, prescribing and care home costs associated with atrial fibrillation in Scotland. BMJ Open, 10(3), e028575. (doi: 10.1136/bmjopen-2018-028575) (PMID:32193256)
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Abstract
Objective:This study aimed to estimate global inpatient, outpatient, prescribing and care home costs for patients with atrial fibrillation using population-based, individual-level linked data. Design:A two-part model was employed to estimate the probability of resource utilisation and costs conditional on positive utilisation using individual-level linked data. Settings:Scotland, 5 years following first hospitalisation for AF between 1997 and 2015. Participants: Patients hospitalised with a known diagnosis of AF or atrial flutter. Primary and secondary outcome measures: Inpatient, outpatient, prescribing and care home costs. Results: The mean annual cost for a patient with AF was estimated at £3785 (95% CI £3767 to £3804). Inpatient admissions and outpatient visits accounted for 79% and 8% of total costs, respectively; prescriptions and care home stay accounted for 7% and 6% of total costs. Inpatient cost was the main driver across all age groups. While inpatient cost contributions (~80%) were constant between 0 and 84 years, they decreased for patients over 85 years. This is offset by increasing care home cost contributions. Mean annual costs associated with AF increased significantly with increasing number of comorbidities. Conclusion: This study used a contemporary and representative cohort, and a comprehensive approach to estimate global costs associated with AF, taking into account resource utilisation beyond hospital care. While overall costs, considerably affected by comorbidity, did not increase with increasing age, care home costs increased proportionally with age. Inpatient admission was the main contributor to the overall financial burden of AF, highlighting the need for improved mechanisms of early diagnosis to prevent hospitalisations.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Ciminata, Dr Giorgio and Wu, Professor Olivia and Geue, Dr Claudia and Langhorne, Professor Peter |
| Creator Roles: | Ciminata, G.Conceptualization, Formal analysis, Writing – original draft, Writing – review and editing Geue, C.Conceptualization, Writing – review and editing Langhorne, P.Conceptualization, Writing – review and editing Wu, O.Conceptualization, Writing – review and editing |
| Authors: | Ciminata, G., Geue, C., Langhorne, P., and Wu, O. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
| Journal Name: | BMJ Open |
| Publisher: | BMJ Publishing Group |
| ISSN: | 2044-6055 |
| ISSN (Online): | 2044-6055 |
| Published Online: | 18 March 2020 |
| Copyright Holders: | Copyright © 2020 The Authors |
| First Published: | First published in BMJ Open 10(3):e028575 |
| Publisher Policy: | Reproduced under a Creative Commons Licence |
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