Economic burden and disparities in healthcare resource use among adult patients with cardiac arrhythmia

Abstract

Background: As of 2012, approximately 4.3 million Americans experience some form of cardiac arrhythmia (CA). Assessment of economic burden and healthcare resource use on the overall CA population is limited.

Objectives: To assess healthcare expenditure and disparities in healthcare resource use in patients with all forms of CA in the US.

Methods: Data from the Medical Expenditure Panel Survey were analyzed between 2004 and 2009. Patients aged≥18 years with any form of CA (identified via International Classification of Disorders Ninth Revision, Clinical Modification [ICD-9-CM] codes) were included. Primary independent variables included age, gender, race/ethnicity, and pharmacotherapy use. Outcomes of interest included total annual healthcare and prescription expenditures (inflation adjusted to 2011), use of anti-arrhythmic agents associated with CA, and inpatient, outpatient, or emergency room visits. Generalized linear models were used to assess the disparities across patient subgroups related to the outcomes.

Results: Annually, 5,750,440 individuals experienced CA in the US. Total direct annual healthcare cost of CA summed up to $US67.4 billion. Non-Hispanic whites and older adult patients had higher expenditures and use of healthcare resources (p<0.05). Female patients had significantly higher prescribed medication expenditures and a lower proportion of inpatient and emergency room visits related to arrhythmia (p<0.05). Patients taking anti-arrhythmic agents had significantly higher expenditure and a lower proportion of emergency department visits related to arrhythmia (p<0.05).

Conclusions: CA represents a substantial economic burden in the US, especially for the older adult population. Patients other than non-Hispanic whites may not have adequate access to healthcare treatment for arrhythmia.