Impact of a dedicated center for atrial fibrillation on resource utilization and costs.
atrial fibrillation
cost
quality
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
revised:
19
12
2022
received:
16
11
2022
accepted:
04
01
2023
pubmed:
21
1
2023
medline:
21
3
2023
entrez:
20
1
2023
Statut:
ppublish
Résumé
Atrial fibrillation (AF) affects millions of Americans each year and can lead to high levels of resource utilization through emergency department (ED) visits and inpatient stays. We hypothesized that referral of patients to a dedicated Center for AF from the ED would reduce costs of care. The University of Pittsburgh Center for AF serves as a rapid referral center for patients with AF to avoid unnecessary inpatient admissions and provide specialized care. Patients that presented to the ED with AF and met prespecified criteria were directed to rapid outpatient follow-up instead of inpatient admission. The primary outcome of interest was 30-day total costs. Secondary outcomes included outpatient costs, inpatient costs, 90-day costs, and inpatient stay characteristics. We identified 96 patients (median age 65, 38% women) referred to the center for AF for a new diagnosis of AF between October 2017 and December 2019 and matched 96 control patients. After 30 days of follow-up, patients referred to the center for AF had a lower average cost ($619 vs. $1252, p < 0.001) compared to controls, driven by lower costs of ED care tempered by slightly higher outpatient costs. Thirty-day admissions and lengths of stay were also lower. These differences were persistent at 90 days. Directing patients with AF that present to the ED to follow-up at a dedicated Center for AF significantly reduced overall costs, while reducing subsequent inpatient admissions and total lengths of stay in the hospital.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial fibrillation (AF) affects millions of Americans each year and can lead to high levels of resource utilization through emergency department (ED) visits and inpatient stays.
HYPOTHESIS
OBJECTIVE
We hypothesized that referral of patients to a dedicated Center for AF from the ED would reduce costs of care.
METHODS
METHODS
The University of Pittsburgh Center for AF serves as a rapid referral center for patients with AF to avoid unnecessary inpatient admissions and provide specialized care. Patients that presented to the ED with AF and met prespecified criteria were directed to rapid outpatient follow-up instead of inpatient admission. The primary outcome of interest was 30-day total costs. Secondary outcomes included outpatient costs, inpatient costs, 90-day costs, and inpatient stay characteristics.
RESULTS
RESULTS
We identified 96 patients (median age 65, 38% women) referred to the center for AF for a new diagnosis of AF between October 2017 and December 2019 and matched 96 control patients. After 30 days of follow-up, patients referred to the center for AF had a lower average cost ($619 vs. $1252, p < 0.001) compared to controls, driven by lower costs of ED care tempered by slightly higher outpatient costs. Thirty-day admissions and lengths of stay were also lower. These differences were persistent at 90 days.
CONCLUSION
CONCLUSIONS
Directing patients with AF that present to the ED to follow-up at a dedicated Center for AF significantly reduced overall costs, while reducing subsequent inpatient admissions and total lengths of stay in the hospital.
Identifiants
pubmed: 36660876
doi: 10.1002/clc.23974
pmc: PMC10018075
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
304-309Informations de copyright
© 2023 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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