Analysis Illustrates the Burden of Atrial Fibrillation on Spending, Resources

Despite the high costs and heavy demand for health services associated with atrial fibrillation (AFib), a new report suggests that states may not be providing residents with the necessary resources to address and manage this common chronic disease.

“AFib in America: State Impact Reports” identify key state-by-state statistics, resources and state health department programs related to the burden of AFib. It was written by The George Washington University School of Public Health and Health Services (GWU) and funded by sanofi-aventis U.S. LLC, the sponsor of AF Stat: A Call to Action for Atrial Fibrillation. The full interactive reports are available at www.AFStat.com.

AFib affects approximately 2.5 million Americans, and its prevalence is expected to increase as the U.S. population ages. It 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.

“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 Christy Ferguson, a professor in 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.”

Among the key findings, the reports show that AFib has an immense, but unrecognized, burden. In fact, Medicare payments where AFib was the primary diagnosis totaled almost $2.3 billion in 2007. Nearly half of these costs were related to hospital inpatient stays, a burden specifically felt by local healthcare providers.

However, despite the significant health and economic burden of AFib, not a single state has a public health program specifically dedicated to educating or supporting patients with AFib. State-level public health programs that do address AFib tend to only include the disease as a part of stroke and heart disease prevention efforts, rather than focusing on the specific risks and consequences of AFib.

“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 Senator Bill Frist, M.D., former Senate majority leader and policy advisor for AF Stat. “The ‘AFib in America: State Impact Reports’ are an important first step to helping them recognize that need and put an AFib action plan in place.”

Also released recently by AF Stat, the AFib Evaluator is an online self-assessment tool designed to provide insight into a user’s risk for developing AFib, or a diagnosed patient’s baseline knowledge of AFib. The AFib Evaluator serves as an example of the type of patient education tools that AFib patients need, but currently lack.

According to Senator Frist, these two new resources take on particular significance as federal and state policymakers join private payers to reduce the cost of healthcare.

“It may appear that many of AFib’s costs are assumed by the federal government through Medicare, but the disease also inflicts a significant burden at the state level,” he said. “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.”