Incidence and temporal pattern of hospital readmissions for patients with atrial fibrillation

ABSTRACT

Background: Atrial fibrillation (AF) is prevalent and has a high cost burden. Among the main drivers of cost is inpatient care; however, little is known about patterns of hospital readmissions for AF.

Objective: To evaluate the incidence and temporal pattern of readmission in AF patients.

Methods: This retrospective, cohort analysis used claims data from the Integrated Healthcare Information Systems National Managed Care Benchmark Database for 2002–2006. Patients hospitalized for AF (primary discharge diagnosis) were identified. Data on the first readmission for AF over 1 year following an index hospitalization were analyzed for chronic AF (any AF-related claims in 1 year before index hospitalization) and newly-diagnosed AF patients (no prior AF-related claims).

Results: Overall, 4174 patients hospitalized with primary AF were identified; 1637 had chronic AF and 2537 newly-diagnosed AF. Mean age of chronic AF patients was 62.4 years and 61.2% were male; for newly-diagnosed AF, mean age was 61.4 years and 57.8% were male. In the year following index hospitalization, 12.5% of chronic AF patients were readmitted for AF, with a mean time to readmission of 142.5 days (median 108 days). Among newly-diagnosed AF patients, 10.1% were readmitted for AF, with a mean time to readmission of 133.8 days (median 112 days). For chronic AF, 17.6%, 43.4%, and 65.8% of readmissions occurred within 1, 3, and 6 months, respectively, versus 22.7%, 44.5%, and 67.2%, respectively, for newly-diagnosed AF.

Limitations: Limited data were available on patients’ clinical profile, treatment patterns, or the reasons for hospitalization/readmission. The term chronic AF only captured patients with a history of AF and data were not available to classify patients according to the presence of paroxysmal, permanent, or persistent AF.

Conclusions: Patients with newly-diagnosed or chronic AF are often readmitted in the year following hospitalization with most readmissions occurring within 6 months of the index hospitalization.

Key words: :

• Atrial fibrillation
• Hospitalization
• Managed care
• Readmissions

Acknowledgments

Declaration of interest: Financial and editorial support for this manuscript have been provided by sanofi-aventis US, Inc.

We would like to acknowledge Essy Mozaffari (sanofi-aventis) for his input into the design of this study. Editorial support was provided by Jon Edwards, PhD and Elizabeth Harvey, PhD (both of UBC Scientific Solutions).

Dr Michael Kim is a research consultant to sanofi-aventis. Dr Jay Lin is an employee of sanofi-aventis. Drs Mohamed Hussein and David Battleman are employees of IMS Health, Inc., which has a research consulting agreement with sanofi-aventis.