Background: Background Atrial flutter (AFL) is a common cardiac rhythm disorder, which often co-exists with atrial fibrillation (AF). AFL is associated with considerable morbidity and diminished quality of life. To date, no study has assessed the incremental healthcare burden associated with AFL as a standalone disease.
Objectives: Objective To examine the incremental healthcare utilization and cost burden associated with incident AFL among adult individuals in the United States (US).
Methods: Methods The 2017-2020 Optum Clinformatics, which is an administrative claims database for commercially insured beneficiaries in the US, were used for study purposes. Patients with an incident diagnosis of AFL were identified (classified as ‘AFL cohort’). Healthcare utilization (medical services use including inpatient visits, emergency room [ER] visits, and other services) and costs were examined, and compared to a ‘control cohort’ of individuals without AFL. The two groups of patients were matched (using matching weights techniques) on baseline characteristics including demographic and clinical characteristics. Regression models were constructed to examine health care utilization (all-cause and cardiovascular-related) and associated medical expenditures including prescription costs and total healthcare costs (calculated per patient per year).
Results: Results A total of 13,270 individuals with incident AFL and 13,683 individuals without incident AFL were identified post-matching. Patients with AFL had significantly greater healthcare utilization including all-cause inpatient visits (relative risk [RR] 2.26 95% CI 2.19-2.33, p< 0.001) and cardiovascular-related inpatient visits (RR 3.27, 95% CI 3.15-3.39, p< 0.001) as compared to the non-AFL comparator cohort. Total healthcare costs were significantly higher among the AFL cohort as compared to the non-AFL control cohort ($71,201 vs. $49,418, p < 0.001). These results persisted when excluding patients with concomitant atrial fibrillation (AF) from the AFL cohort. Sub-analyses by type of AFL (atypical, typical, and unspecified) also revealed similar results.
Conclusions: Conclusion Study results highlight the significant healthcare impact of AFL with or without concomitant AF, and could serve to guide and support policy makers in resource allocation decisions.
