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The trends of atrial fibrillation-related hospital visit and cost, treatment pattern and mortality in Korea : 10-year nationwide sample cohort data

Other Titles
 국민건강 보험 표본코호트 데이터 분석을 통한 10년간 한국의 심방세동 관련 입원과 의료비용, 치료 행태 및 사망 경향 
Authors
 이한철 
College
 Graduate School, Yonsei University 
Department
 Dept. of Medicine 
Degree
석사
Issue Date
2017
Abstract
Background: The change of in-hospital and out-hospital treatments,
and hospital costs for atrial fibrillation (AF) were not well known in
rapidly aging Asian countries. This study is to examine the trends of AF
management and outcomes in Korea.
Subjects and Methods: In the sample cohort from Korean National
Health Insurance Data Sample Cohort (K-NHID-Sample Cohort) from
2004 through 2013, we identified patients with AF and hospital visit
records using Korean Classification of Diseases, 6th Revision (KCD-6).
Hospital cost, prescribed medications, radiofrequency catheter ablation
(RFCA), morbidity and mortality were identified.
Results: AF-related hospitalization and outpatient clinic visits increased
by 2.19 and 3.06-fold, respectively. While the total cost increased from
3.6 to 11.3 billion won (p<0.001), the mean cost per patient increased
from 0.68 to 0.83 million won (p<0.001). Although the mean
CHA2DS2-VASc score increased from 3.5 to 4.4 in the total AF
population, the proportion of patients who receive anticoagulation
therapy with warfarin showed no significant change for the decade. The proportion of hospitalization for RFCA was increased (0.4% to 1.1%,
p<0.001). All-cause mortality (6.7% to 5.0%), cardiovascular mortality
(1.4% to 1.1%) and stroke-related death (1.3% to 0.8%) showed a modest
decrease from 2004 to 2013.
Conclusion: During the last decade, AF-related hospitalization and
outpatient clinic visits have increased with the increase of many other
comorbidities, whereas the rate of anticoagulation did not improved.
Although mortality in patients with AF showed a modest decrease from
2004 to 2013, proper anticoagulation therapy is warranted for the
improvement of public health.
Files in This Item:
TA02077.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 2. Thesis
Yonsei Authors
Lee, Han Cheol(이한철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173601
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