AFib Costs, Medicare Impact Detailed

Despite the high costs and heavy demand for atrial fibrillation services, states aren't providing their residents with the resources to address and manage the chronic disease, research suggests.

AFib in America: State Impact Reports identifies key state-by-state statistics, resources and state health department programs related to the impact of AFib. It was written by The George Washington University School of Public Health and Health Services.

AFib is the most common form of heart arrhythmia, affecting 2.5 million Americans, and its prevalence is expected to increase as the population ages. AFib increases risk for stroke by five times, worsens other heart diseases, and doubles the risk of death. Patients with AFib tend to use more healthcare services than patients without AFib, including time in the hospital, the report says.

Medicare payments where AFib was the primary diagnosis totaled almost $2.3 billion in 2007, of which nearly half of the costs were related to hospital inpatient stays, according to the report.

"Atrial fibrillation is costly and can become debilitating as it worsens, yet it does not share the same priority on the public health agenda that other chronic diseases have," said Prof. Christy Ferguson, of the Department of Health Policy, School of Public Health and Health Services, GWU. "This report calls attention to the lack of resources about AFib, alerting policymakers, state health officials, and other health leaders to better educate residents about this common but misunderstood disease."

Despite the health and economic burden of AFib, no state has a public health program specifically dedicated to educating or supporting patients with AFib. State-level public health programs generally include AFib as a part of stroke and heart disease prevention efforts, rather than focusing on the specific risks and consequences of AFib, the report says.

"Just as patients need to comprehensively manage their AFib, health leaders need to develop and implement comprehensive programs that address the impact of AFib in their home states," said Bill Frist, MD, former U.S. Senate Majority Leader and policy advisor for AF Stat.

Frist said there is an incorrect assumption at the state level that Medicare will absorb much of the costs associated with AFib. "Individual states feel AFib's impact on their residents' health, productivity, and quality of life. Local hospitals and providers often assume the burden of repeated hospitalizations and care for AFib patients. As health leaders work to lower the costs of expensive chronic diseases, AFib must be a part of the discussion," Frist said.

Connecticut is the state with the highest percentage (8.8) of Medicare recipients who have used healthcare services because of AFib. Hawaii is the state with the least (3.3%).

The research was financed by drugmaker Sanofi-Aventis U.S., LLC.