Healthcare utilization and expenditures in patients with atrial fibrillation treated with catheter ablation.

ABSTRACT

AIM: The aim was to estimate the impact of catheter ablation on short- and long-term healthcare utilization and expenditures among atrial fibrillation (AF) patients in general and Medicare populations. METHODS: Data were analyzed from The MarketScan(®) Databases. MarketScan data contain deidentified patient-level records from employer-sponsored and public health insurance plans. Multivariable regression models for utilization and expenditures were built for all patients, with subanalyses performed for patients ≥65 years. Results were compared to preablation figures and reported for 5 time groups, based on duration of available postablation follow-up 6-12 months; 12-18 months; 18-24 months; 24-30 months; and 30-36 months. RESULTS: A total of 3,194 patients were identified who had undergone catheter ablation for treatment of AF, had continuous enrollment in the database 6 months prior to first ablation, and had at least 1-year follow-up postablation. Compared to the 6 months prior to ablation, there were significant reductions in the number of outpatient appointments, inpatient days, and emergency room visits in the total study population and in the subset ≥65 years. There was a statistically significant (P < 0.01) decrease in total healthcare expenditures across 4 of the 5 6-month time periods, with annual savings ranging from $3,300 to $9,200. For patients ≥65 years, annual savings ranged from $3,200 to $9,200. Drug utilization also significantly declined (P < 0.01), with average annual medication savings ranging from $670 to $890, and from $740 to $880 for patients ≥65 years. CONCLUSION: Catheter ablation for AF reduced healthcare utilization and expenditures up to 3 years postablation. This reduction was consistent, significant, and had implications for general and Medicare populations.