Policy, Payment & Practice -> Clinical Quality Measures and Outcomes D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-072 - Healthcare Utilization And Cost Among Patients With Paroxysmal Versus Persistent Atrial Fibrillation Before And After Undergoing Catheter Ablation (ID 907)


Background: Catheter ablation (CA) reduces atrial fibrillation (AF) burden and improves health-related quality of life. The relationship between CA, healthcare utilization (HU), and AF type [paroxysmal AF (pAF) vs. persistent AF (PsAF)] remains unclear.
Objective: To compare HU and costs among patients with pAF and PsAF for the year before and after CA.
Methods: pAF and PsAF patients (≥ 19 yrs) undergoing CA (2016-2018) were identified using the Optum (UnitedHealth) database. Primary outcomes were inpatient admissions, emergency department [ED] visits, office visits, cardioversion, and anti-arrhythmic drug (AAD) use. Costs (2018 US$) were compared for the year before and after CA. McNemar’s test and Wilcoxon signed-rank test was used to assess the proportion and mean changes in the study outcomes.
Results: A total of 2,802 pAF and 1,914 PsAF patients were included. Significant reductions in the proportion of patients with AF-related inpatient admissions, ED visits, and cardioversions were observed for pAF and PsAF patients (Figure). The proportion of patients ≥1AAD prescription fill decreased for pAF but not PsAF patients (Figure). The average AF related inpatient (pAF: 29%, p<.0001; PsAF: 33%, p<.0001), ED visit (pAF: 76%, p<.0001; PsAF: 70%, p<.0001), DCCV (pAF: 69%, <.0001, PsAF: 56%, p<.0001) office visit (pAF: 15%,p<.0001; PsAF: 16%, p<.0001) and AAD (pAF: 25%, p<.0001; PsAF: 7%, p=.01) costs decreased significantly among both AF subgroups but were higher in the PsAF group.
Conclusion: Significant reductions in HU and costs were observed among pAF and PsAF patients undergoing CA. Based on these data, a strategy of earlier CA may have the potential to reduce long term HU and costs.