Cost of an Emerging Epidemic: an Economic Analysis of Atrial Fibrillation in the UK

Overview

Journal Heart

Date 2004 Feb 18

PMID 14966048

Citations 174

Authors

S Stewart

N F Murphy

N Murphy

A Walker

A McGuire

J J V McMurray

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the cost of atrial fibrillation (AF) to health and social services in the UK in 1995 and, based on epidemiological trends, to project this estimate to 2000. DESIGN, SETTING, AND MAIN OUTCOME MEASURES: Contemporary estimates of health care activity related to AF were applied to the whole population of the UK on an age and sex specific basis for the year 1995. The activities considered (and costs calculated) were hospital admissions, outpatient consultations, general practice consultations, and drug treatment (including the cost of monitoring anticoagulant treatment). By adjusting for the progressive aging of the British population and related increases in hospital admissions, the cost of AF was also projected to the year 2000.

Results: There were 534 000 people with AF in the UK during 1995. The "direct" cost of health care for these patients was 244 million pounds sterling (approximately 350 million euros) or 0.62% of total National Health Service (NHS) expenditure. Hospitalisations and drug prescriptions accounted for 50% and 20% of this expenditure, respectively. Long term nursing home care after hospital admission cost an additional 46.4 million pounds sterling (approximately 66 million euros). The direct cost of AF rose to 459 million pounds sterling (approximately 655 million euros) in 2000, equivalent to 0.97% of total NHS expenditure based on 1995 figures. Nursing home costs rose to 111 million pounds sterling (approximately 160 million euros).

Conclusions: AF is an extremely costly public health problem.

Citing Articles

[Catheter ablation in patients with heart failure-who benefits?].

Bergau L, Sciacca V, Sohns C Herzschrittmacherther Elektrophysiol. 2025; 36(1):3-9.

PMID: 39883128 DOI: 10.1007/s00399-025-01066-w.

Cost-effectiveness analysis of anticoagulation options for non-valvular atrial fibrillation in Iran.

Rezaei S, Bavandpour M, Mobinizadeh M, Daroudi R BMC Res Notes. 2024; 17(1):345.

PMID: 39593086 PMC: 11590557. DOI: 10.1186/s13104-024-07004-2.

A Crowdsourced AI Framework for Atrial Fibrillation Detection in Apple Watch and Kardia Mobile ECGs.

Rad A, Kirsch M, Li Q, Xue J, Sameni R, Albert D Sensors (Basel). 2024; 24(17).

PMID: 39275619 PMC: 11398038. DOI: 10.3390/s24175708.

Watchman vs. Amulet for Left Atrial Appendage Closure: Current Evidence and Future Perspectives.

Frazzetto M, Sanfilippo C, Costa G, Contrafatto C, Giacalone C, Scandura S J Clin Med. 2024; 13(16).

PMID: 39200792 PMC: 11355803. DOI: 10.3390/jcm13164651.

[Atrial fibrillation and heart failure].

Bergau L Inn Med (Heidelb). 2024; 65(8):755-761.

PMID: 39007960 DOI: 10.1007/s00108-024-01743-x.

References

Howitt A, Armstrong D . Implementing evidence based medicine in general practice: audit and qualitative study of antithrombotic treatment for atrial fibrillation. BMJ. 1999; 318(7194):1324-7. PMC: 27873. DOI: 10.1136/bmj.318.7194.1324. View

Ryder K, Benjamin E . Epidemiology and significance of atrial fibrillation. Am J Cardiol. 1999; 84(9A):131R-138R. DOI: 10.1016/s0002-9149(99)00713-4. View

Stewart S, Murphy N, Murphy N, Walker A, McGuire A, McMurray J . The current cost of angina pectoris to the National Health Service in the UK. Heart. 2003; 89(8):848-53. PMC: 1767798. DOI: 10.1136/heart.89.8.848. View

Lee T, Alderman M . Malignant hypertension. Declining mortality rate in New York City, 1958 to 1974. N Y State J Med. 1978; 78(9):1389-91. View

Stewart S, Macintyre K, MacLeod M, BAILEY A, Capewell S, McMurray J . Trends in hospital activity, morbidity and case fatality related to atrial fibrillation in Scotland, 1986--1996. Eur Heart J. 2001; 22(8):693-701. DOI: 10.1053/euhj.2000.2511. View

Ezekowitz M . Atrial fibrillation: the epidemic of the new millennium. Ann Intern Med. 1999; 131(7):537-8. DOI: 10.7326/0003-4819-131-7-199910050-00011. View

Macintyre K, Capewell S, Stewart S, Chalmers J, Boyd J, Finlayson A . Evidence of improving prognosis in heart failure: trends in case fatality in 66 547 patients hospitalized between 1986 and 1995. Circulation. 2000; 102(10):1126-31. DOI: 10.1161/01.cir.102.10.1126. View

Wolf P, Mitchell J, Baker C, Kannel W, DAgostino R . Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med. 1998; 158(3):229-34. DOI: 10.1001/archinte.158.3.229. View

Capewell S, Macintyre K, Stewart S, Chalmers J, Boyd J, Finlayson A . Age, sex, and social trends in out-of-hospital cardiac deaths in Scotland 1986-95: a retrospective cohort study. Lancet. 2001; 358(9289):1213-7. DOI: 10.1016/S0140-6736(01)06343-7. View

10.

Morrison C, McMurray J . Heart failure: the Cinderella of cardiology?. Public Health. 1997; 111(5):351-4. View

11.

Kendrick S, Clarke J . The Scottish Record Linkage System. Health Bull (Edinb). 1993; 51(2):72-9. View

12.

Evers S, Engel G, Ament A . Cost of stroke in The Netherlands from a societal perspective. Stroke. 1997; 28(7):1375-81. DOI: 10.1161/01.str.28.7.1375. View

13.

Chugh S, Blackshear J, Shen W, Hammill S, Gersh B . Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol. 2001; 37(2):371-8. DOI: 10.1016/s0735-1097(00)01107-4. View

14.

Ryden L, Asinger R, Cannom D, Crijns H, Frye R, Halperin J . ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology.... Circulation. 2001; 104(17):2118-50. View

15.

Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray J . The current cost of heart failure to the National Health Service in the UK. Eur J Heart Fail. 2002; 4(3):361-71. DOI: 10.1016/s1388-9842(01)00198-2. View

16.

Harley K, Jones C . Quality of Scottish Morbidity Record (SMR) data. Health Bull (Edinb). 1996; 54(5):410-7. View

17.

Sudlow M, Thomson R, Thwaites B, Rodgers H, Kenny R . Prevalence of atrial fibrillation and eligibility for anticoagulants in the community. Lancet. 1998; 352(9135):1167-71. DOI: 10.1016/S0140-6736(98)01401-9. View

18.

Bruce M, Griffiths C, Brock A, Majeed A . Trends in mortality and hospital admissions associated with epilepsy in England and Wales during the 1990s. Health Stat Q. 2004; (21):23-9. View

19.

Majeed A, Moser K, Carroll K . Trends in the prevalence and management of atrial fibrillation in general practice in England and Wales, 1994-1998: analysis of data from the general practice research database. Heart. 2001; 86(3):284-8. PMC: 1729916. DOI: 10.1136/heart.86.3.284. View

20.

Frost L, Engholm G, Moller H, Husted . Decrease in mortality in patients with a hospital diagnosis of atrial fibrillation in Denmark during the period 1980-1993. Eur Heart J. 1999; 20(21):1592-9. DOI: 10.1053/euhj.1999.1713. View