PCV16 Associations Between Patient Demographics, Pharmacotherapy Use, and Cost, Resource Utilization, and Quality-of-Life Burden in Adult Cardiac Arrhythmia Patients

Abstract

To examine a cohort of patients with all forms of cardiac arrhythmia (CA) and identify factors associated with cost of care, health care resource utilization, antiarrhythmic agent use, and quality of life. This retrospective database analysis utilized the household component data from 2004 to 2009 Agency for Healthcare Research and Quality Medical Panel Expenditure Survey. Patients aged ≥ 18 and had any form of CA (identified via ICD-9-CM codes 427.0-427.2, 427.31-427.32, 427.60-427.61, 427.69, 427.81, 427.89, 427.9, 785.0-785.1) were included. Primary independent variables of interest included age, gender, race/ethnicity, and pharmacotherapy use. Total annual health care expenditure, total annual prescribed medicine expenditure, physical and mental component summary scores (PCS and MCS) of the Short-Form 12 version 2 (SF-12), EuroQoL-5D (EQ-5D) utility scores (US version), proportion of patients using antiarrhythmic medications, number of prescribed medications associated with their cardiac arrhythmia, and proportion of patients with inpatient, outpatient, or emergency room visits were the primary outcomes of interest. Multivariate ordinary least squares (OLS) and generalized linear models (GLM) were used to analyze factors related to the aforementioned outcomes. To provide national estimates, all results were weighted and used standard errors (SE) calculated via Taylor-series approaches. Annually, 5,750,440 non-institutionalized US persons were estimated to suffer from cardiac arrhythmia between 2004 and 2009. Higher health care expenditure and utilization appeared in non-Hispanic whites and patients aged ≥ 65 (p<0.05). As compared to male patients, females had significantly higher prescribed medication expenditure, lower proportion of inpatient and emergency department visits related to arrhythmia, and lower PCS score (p<0.05). Patients on antiarrhythmics had significantly higher health care expenditures, lower proportion of emergency department visits related to arrhythmia, and higher MCS score (p<0.05) compared with their counterparts. Potential health disparities exist across age, gender, race, and antiarrhythmic use among CA patients.