Having atrial fibrillation increases the cost of stroke hospitalization in younger adults by $4,905, with patients between 18 and 54 years old incurring the highest cost, according to a study published online April 7 in Stroke.
Most stroke-related cost analyses focus on the elderly. Guijing Wang, PhD, of the heart disease and stroke prevention division of the Centers for Disease Control and Prevention in Atlanta, and colleagues instead looked at stroke in patients between the ages of 18 and 65 who had atrial fibrillation. While stroke occurs less frequently in this age group, its prevalence has been increasing.
They accessed data from the MarketScan Commercial Claims and Encounters database between 2010 and 2012 to find patients with a primary diagnosis of ischemic stroke and noncapitated health insurance plans. They identified 40,082 patients. Of those with nonrepeat stroke admission, 7.2 percent had atrial fibrillation. Of those with a repeat stroke admission, 6 percent had atrial fibrillation.
The mean costs for nonrepeat admissions were $4,991 higher among patients with atrial fibrillation vs. those without. After adjustments, the difference was $4,905. Patients between the ages of 18 and 55 had higher costs than those between 55 and 64, at $5,084 vs. $4,854. Patients in the West had higher cost than those in other regions.
The cost difference between those with and without atrial fibrillation among patients with repeat stroke admissions was not statistically significant, except in the 55 to 64 age group. That group had a mean cost increase of $3,537.
The adjusted $4,905 increase for nonrepeat stroke patients accounted for 20.6 percent of the total hospital costs. Wang et al suggested their findings had implications for public health and research programs because presently many management and prevention efforts target only the elderly.
“[S]troke interventions such as AFib management among younger adults, as well as older adults, may have greater economic impact,” they wrote.
They pointed out that the data didn’t capture patients with no insurance, government insurance and capitated insurance, and that atrial fibrillation often is asymptomatic and not detected. Those limitations could affect their estimates of cost and atrial fibrillation-associated stroke.