Abstract 258: The Direct Healthcare Expenditures of Mitral Valve Disease: Evidence From US National Survey Data

Abstract

Objectives: This study quantified the incremental direct healthcare expenditures of mitral valve disease (MVD) to insurers and individuals, stratified by asymptomatic and symptomatic disease status. Methods: Using 1996-2011 data from the United States (US) Medical Expenditure Panel Survey (MEPS), a large nationally-representative database, this study performed multivariate analyses of the incremental annual healthcare expenditures for insurers and out-of-pocket expenditures for individuals with MVD compared to individuals with no valvular disease. The healthcare expenditures were reported at the individual and US aggregate levels. Individuals with MVD were identified by International Classification of Disease Codes, 9th revision and stratified as either symptomatic or asymptomatic based on the presence of comorbid conditions. Sensitivity analyses were performed to test the robustness of the results. All expenditure data were adjusted to 2011 using the Medical Care component of the Consumer Price Index (CPI). Results: The MEPS database included 1,051 individuals with MVD. Asymptomatic individuals comprised 70% (736) of the population. Asymptomatic MVD individuals incurred $1,755 more overall annual healthcare expenditures per individual compared to those without valvular disease. Symptomatic MVD individuals incurred $5,163 more overall annual healthcare expenditures per individual compared to those without valvular disease. For both asymptomatic and symptomatic patients, the majority of direct healthcare expenditures were borne by the insurer ($1,360 and $4,718, respectively) rather than the individual ($395 and $445, respectively). When aggregated to the US population, MVD accounted for an incremental annual expenditure of $2.6 billion. Asymptomatic MVD expenditures were $1.1 billion and symptomatic, $1.5 billion. Sensitivity analysis indicated that the incremental annual expenditures ranged from $2.1 billion to $3.1 billion. Conclusions: These findings indicated that the incremental burden of MVD was substantial in the overall US population. The majority of MVD patients are over 55 years of age and likely comprise a disproportionate share of the US aggregate burden. Further research is necessary to understand the individual economic burden in this age group.