Healthcare Resource Utilization in Patients with Newly Diagnosed Atrial Fibrillation: A Global Analysis from the GARFIELD-AF Registry

Lorenzo G Mantovani^{1

2}, Paolo Cozzolino¹, Pietro Ferrara^{1

2}, Saverio Virdone³, A John Camm⁴, Freek W A Verheugt⁵, Jean-Pierre Bassand^{3

6}, Alexander G G Turpie⁷, Werner Hacke⁸, Gloria Kayani³, Samuel Z Goldhaber⁹, Shinya Goto¹⁰, Karen S Pieper³, Bernard J Gersh¹¹, Keith A A Fox¹², Sylvia Haas¹³, Martin van Eickels¹⁴, Ajay K Kakkar³, On Behalf Of The Garfield-Af Investigators

Affiliations

¹ Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy.
² Laboratory of Public Health, Istituto Auxologico Italiano-IRCCS, 20165 Milan, Italy.
³ Thrombosis Research Institute, London SW3 6LR, UK.
⁴ Cardiovascular Clinical Academic Group, St. George's University of London, London SW17 0RE, UK.
⁵ Onze Lieve Vrouwe Gasthuis (OLVG), 1091 AC Amsterdam, The Netherlands.
⁶ Department of Cardiology, University of Besançon, 25030 Besançon, France.
⁷ Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada.
⁸ Department of Neurology, Ruprecht-Karls-University of Heidelberg, 69120 Heidelberg, Germany.
⁹ Division of Cardiovascular Medicine, Harvard Medical School, Boston, MA 02115, USA.
¹⁰ Department of Medicine (Cardiology), Tokai University School of Medicine, Isehara 259-1193, Japan.
¹¹ Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Rochester, NY 55905, USA.
¹² Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4TJ, UK.
¹³ Formerly Department of Medicine, Technical University of Munich, 81675 Munich, Germany.
¹⁴ Bayer AG, 13353 Berlin, Germany.

PMID: 36900643
PMCID: PMC10000823
DOI: 10.3390/healthcare11050638

Healthcare Resource Utilization in Patients with Newly Diagnosed Atrial Fibrillation: A Global Analysis from the GARFIELD-AF Registry

Lorenzo G Mantovani et al. Healthcare (Basel). 2023.

. 2023 Feb 21;11(5):638.

doi: 10.3390/healthcare11050638.

Authors

Affiliations

¹ Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy.
² Laboratory of Public Health, Istituto Auxologico Italiano-IRCCS, 20165 Milan, Italy.
³ Thrombosis Research Institute, London SW3 6LR, UK.
⁴ Cardiovascular Clinical Academic Group, St. George's University of London, London SW17 0RE, UK.
⁵ Onze Lieve Vrouwe Gasthuis (OLVG), 1091 AC Amsterdam, The Netherlands.
⁶ Department of Cardiology, University of Besançon, 25030 Besançon, France.
⁷ Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada.
⁸ Department of Neurology, Ruprecht-Karls-University of Heidelberg, 69120 Heidelberg, Germany.
⁹ Division of Cardiovascular Medicine, Harvard Medical School, Boston, MA 02115, USA.
¹⁰ Department of Medicine (Cardiology), Tokai University School of Medicine, Isehara 259-1193, Japan.
¹¹ Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Rochester, NY 55905, USA.
¹² Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4TJ, UK.
¹³ Formerly Department of Medicine, Technical University of Munich, 81675 Munich, Germany.
¹⁴ Bayer AG, 13353 Berlin, Germany.

PMID: 36900643
PMCID: PMC10000823
DOI: 10.3390/healthcare11050638

Abstract

The management of atrial fibrillation (AF), the most common sustained arrhythmia, impacts healthcare resource utilization (HCRU). This study aims to estimate global resource use in AF patients, using the GARFIELD-AF registry. A prospective cohort study was conducted to characterize HCRU in AF patients enrolled in sequential cohorts from 2012 to 2016 in 35 countries. Components of HCRU studied were hospital admissions, outpatient care visits, and diagnostic and interventional procedures occurring during follow-up. AF-related HCRU was reported as the percentage of patients demonstrating at least one event and was quantified as rate-per-patient-per-year (PPPY) over time. A total of 49,574 patients was analyzed, having an overall median follow-up of 719 days. Almost all patients (99.5%) had at least one outpatient care visit, while hospital admissions were the second most frequent medical contact, with similar proportions in North America (37.5%) and Europe (37.2%), and slightly higher in the other GARFIELD-AF countries (42.0%; namely Australia, Egypt, and South Africa). Asia and Latin America showed lower percentages of hospitalizations, outpatient care visits, and diagnostic and interventional procedures. Analyses of GARFIELD-AF highlighted the vast AF-related HCRU, underlying significant geographical differences in the type, quantity, and frequency of AF-related HCRU. These differences were likely attributable to health service availability and differing models of care.

Keywords: atrial fibrillation; healthcare resource utilization; inpatient care; outpatient care.

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Conflict of interest statement

L.G.M. received grants and personal fees from Bayer AG, Daiichi Sankyo, Pfizer and Boehringer Ingelheim. A.J.C. received institutional grants and personal fees from Bayer, Boehringer Ingelheim, Pfizer/BMS, Daiichi Sankyo; F.W.A.V. received grants from Bayer Healthcare; personal fees from Bayer Healthcare, BMS/Pfizer, DaiichiSankyo, and Boehringer-Ingelheim; J.P.B. received personal fees from the Thrombosis Research Institute; A.G.G.T. received personal fees from Bayer Healthcare, Janssen Pharmaceutical Research & Development, and Portola; W.H. personal fees from Bayer AG; S.Z.G. received research support from Boehringer-Ingelheim, BMS, BTG EKOS, Daiichi, Janssen, NHLBI, and the Thrombosis Research Institute; S.Z.G. also served as a consultant for Agile, Bayer, Boehringer-Ingelheim, BMS, Daiichi, Janssen and Zafgen; S.G. received personal fees from Thrombosis Research Institute and the American Heart Association, as well as grants from Sanofi, Pfizer, Ono, Bristol Myer Squibb, the Vehicle Racing Commemorative Foundation and Nakatani Foundation for Advancement of Measuring Technologies in Biomedical Engineering; K.S.P. serves as consultant for Thrombosis Research Institute, AstraZeneca, and Bayer; B.J.G. is a data safety monitoring board member at Mount Sinai St Luke’s, Boston Scientific Corporation, St Jude Medical Inc., Janssen Research & Development LLC, Thrombosis Research Institute, Duke Clinical Research Institute, Duke University, Kowa Research Institute Inc, Cardiovascular Research Foundation, and Medtronic; he also received general consulting for Janssen Scientific Affairs, Xenon Pharmaceuticals and Sirtex Medical Limited; K.A.A.F. has received grants and personal fees from Bayer/Janssen and AstraZeneca and personal fees from Sanofi/Regeneron and Verseon; S.H. received personal fees from Aspen, Bayer, BMS, Daiichi-Sankyo, Portola, Sanofi; M.v.E. is an employee of Bayer AG; A.K.K. received research support from Bayer AG and Sanofi, and personal fees from Bayer AG, Janssen, Pfizer, Sanofi, Verseon and Anthos Therapeutics; P.C., P.F., S.V. and G.K. declare no conflicts of interest.

Figures

**Figure 1**
Regression-adjusted per-patient-per-year rates of healthcare resource utilization in patients with atrial fibrillation in cohort Group A (GARFIELD–AF Cohorts 1 and 2) by region. Abbreviations: IRR, incidence rate ratio; 95% CI, 95% confidence interval; ER, emergency room.

**Figure 2**
Regression-adjusted per-patient-per-year rates of healthcare resource utilization in patients with atrial fibrillation in cohort Group B (GARFIELD–AF Cohorts 4 to 6) by region. Abbreviations: IRR, incidence rate ratio; 95% CI, 95% confidence interval; ER, emergency room.

See this image and copyright information in PMC

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Healthcare Resource Utilization in Patients with Newly Diagnosed Atrial Fibrillation: A Global Analysis from the GARFIELD-AF Registry

Affiliations

Healthcare Resource Utilization in Patients with Newly Diagnosed Atrial Fibrillation: A Global Analysis from the GARFIELD-AF Registry

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

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