Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications D-PO05 - Poster Session V (ID 39) Poster

D-PO05-125 - The Impact Of High-utilizer Atrial Fibrillation Patients To The Health System In Canada (ID 558)

 H. Halperin: Nothing relevant to disclose.


Background: The Canadian Institute for Health Information (CIHI) has recognized a dynamic cohort of complex, high systems users, as patients who account for the top 10% of acute care costs.
Objective: To identify clinical characteristics, healthcare use, and cost differences between high-utilizer nonvalvular atrial fibrillation (NVAF) patients compared to all other NVAF patients.
Methods: Patients >20 years presenting to emergency department (ED) or were hospitalized with NVAF (ICD code I48) were identified in Alberta between 2011- 2015 (AF-pop). A second cohort consisted of NVAF patients who meet the CIHI’s criteria for high-utilizers (AF-high). Healthcare use was defined as visits to the hospital, ED and physician office over the study period and costs included hospitalization, drugs, and physician billing (2011/12-2012/13).
Results: Of the 77 704 patients that fulfilled the CIHI criteria for high-utilizers, 15 464 (20%) had NVAF. The AF-high group accounted for 32% of all NVAF patients in Alberta (n = 48 338). Compared to AF-pop, the AF-high cohort were older, (77.4 years vs. 74.1 years, p<0.001), with more cardiovascular co-morbidity and more were at high risk of stroke (CHA2DS2-Vasc > 2; 94.3% vs. 85.7% p<0.001). The healthcare visits and costs attributed to the AF-high patients are shown in Figure 1.
Conclusion: In this population-based study, one in five patients in the top 10% of all acute care costs has NVAF. High-utilizer AF accounts for a disproportionality large amount of healthcare use and costs compared to all other AF patients. Aggressive management strategies aimed at this group are needed to reduce the significant burden on the healthcare system