Dedicated AF center reduces hospital costs, readmissions
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Directing patients with atrial fibrillation who presented to the ED to follow‐up at a dedicated AF center reduced overall costs, subsequent inpatient admissions and total length of hospital stay compared with usual care, data show.
“When the option of rapid triage and timely referral to a specialized center for AF was present, cost of care was impacted mostly due to reduced hospitalizations,” Sandeep K. Jain, MD, professor of medicine at the University of Pittsburgh School of Medicine and director of the Center for Atrial Fibrillation at UPMC Heart and Vascular Institute, told Healio. “This difference persisted for 90 days of follow-up, such that early triage to the outpatient setting did not result in a rebound increase in future ED or inpatient encounters.”
Data were derived from Medhekar A, et al. Clin Cardiol. 2023;doi:10.1002/clc.23974.
Jain and colleagues analyzed data from 96 adults who were referred to the University of Pittsburgh Center for Atrial Fibrillation, which provides specialized AF care after a patient presents to the ED with AF and meets prespecified criteria to allow rapid outpatient follow‐up instead of inpatient admission. The median age of patients was 65 years and 38% were women; referrals to the AF center took place between October 2017 and December 2019. Researchers matched AF patients with 96 controls who were not referred to the center. The primary outcome was 30‐day total costs. Secondary outcomes included outpatient costs, inpatient costs, 90‐day costs and inpatient stay characteristics.
The findings were published in Clinical Cardiology.
After 30 days of follow‐up, patients referred to the center for AF had a lower average cost compared with controls (mean, $619 vs. $1,252; P < .001). Researchers found the savings were due to lower costs of ED care, tempered by slightly higher outpatient costs. Readmissions within 30 days and mean length of stay were also lower for those referred to the specialty AF center, with the differences persisting at 90 days (P < .001 for all).
“In the era of limited health care resources, ED personnel are more comfortable with early discharge when outpatient access is freely available to allow rapid follow-up,” Jain told Healio. “This has implications for the way health systems approach optimal resource use.”
Jain said the similar cost analyses including payor data can provide a more complete picture of the true cost of care and larger patient cohorts.
For more information:
Sandeep K. Jain, MD, can be reached at jainsk@upmc.edu.
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