Economic Impact of Stroke Episode in Patients Previous Diagnosed with Atrial Fibrillation in Private Health System in Brazil

Abstract

Objectives: To compare the economic burden and health care utilizations of U.S. veteran patients diagnosed with hypertension. MethOds: A retrospective database analysis was performed using the Veterans Health Administration Medical SAS datasets from October 1, 2008 to September 30, 2012. Patients diagnosed with hypertension were identified using International Classification of Disease 9th Revision Clinical Modification (ICD-9-CM) diagnosis codes 401.x, 402.xx, 403.xx, and 404. xx, with the first diagnosis date designated as the index date. A comparison group of patients without hypertension but of the same age, region, gender and index year were identified and matched by baseline Charlson Comorbidity Index. The index date for the comparator group was randomly chosen to reduce selection bias. Patients in both groups were required to be at least 18 years old, and have continuous medical and pharmacy benefits 1 year pre-and 1 year post-index date. Study outcomes, including health care costs and utilizations, were compared between the disease and comparator groups using 1:1 propensity score matching. Results: A total of 2,422,810 patients were included in the hypertension and comparison cohorts. After 1:1 matching, a total of 748,857 patients were matched from each group, and baseline characteristics were well-balanced. Patients diagnosed with hypertension utilized more health care resources for inpatient (8.21% vs. 1.01%, p< 0.01), emergency room (ER) (12.78% vs. 3.60%, p< 0.01), physician office (99.43% vs. 39.45%, p< 0.01), outpatient visits (99.61% vs. 40.14%, p< 0.01), and pharmacy visits (85.51% vs. 35.66%, p< 0.01). The disease group also had higher patient expenditures for inpatient