Vol.:(0123456789) 1 3 The European Journal of Health Economics https://doi.org/10.1007/s10198-018-0961-7 ORIGINAL PAPER Annual costs attributed to atrial fbrillation management: cross‑sectional study of primary healthcare electronic records Marc Casajuana 1,2  · Maria Giner‑Soriano 1,2,3  · Albert Roso‑Llorach 1,2  · Cristina Vedia 2,4  · Concepció Violan 1,2  · Rosa Morros 1,2,3,5 Received: 21 July 2017 / Accepted: 14 February 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Atrial fbrillation (AF) is the most common chronic arrhythmia, with increasing healthcare and economic burden and a preva- lence which increases with progressive ageing. This study aims to describe overall annual costs per patient for management of non-valvular AF in a primary healthcare (PHC) setting and compare these costs between the groups of patients treated with vitamin K antagonists, antiplatelets or non-treated through a population-based study conducted with electronic health records. We analysed annual costs per person of 19,787 patients in 2012; PHC visits, hospital admissions, AF-related events requiring hospital admission, referrals to secondary specialists, sick leave, diagnostic tests and laboratory tests at PHC level, including INR determinations performed in PHC, and drug therapy. Higher costs of AF management were associated with increasing age, male sex, stroke and bleeding risks, comorbidities and occurrence of events associated to AF. The sensitivity analyses conducted showed that PHC visits and hospitalizations represented the most important part of overall costs for all patients. Keywords Atrial fbrillation · Costs · Primary healthcare · Electronic health records · Stroke · Haemorrhage JEL I10 Introduction Atrial fbrillation (AF) is the most common chronic arrhyth- mia, with increasing healthcare burden, because of an ageing population [1]. Its estimated prevalence is approximately 1–2% of general population [1, 2]. It increases with age, from 0.5% in people under 50 up to 17% in people over 80 years of age [3, 4]. AF increases the risk of stroke by fvefold, and one in fve strokes is attributed to this arrhythmia [5]. This increase in AF and stroke incidence and prevalence poses a challenge to healthcare systems, as it entails high social and economic costs [1, 6]. Despite representing a progressively increasing economic burden, there are not many studies estimating overall costs of AF management. Ringborg et al. conducted the Euro Heart Survey on AF, which is an observational study among car- diology practices in Europe. They estimated costs of diag- nostic procedures, laboratory measurements, interventional procedures, drug therapy, inpatient care, and work loss due to AF [6]. In Spain, Hidalgo-Vega et al. conducted an observational study in AF patients treated with vitamin K * Maria Giner-Soriano mginer@idiapjgol.info Marc Casajuana mcasajuana@idiapjgol.info Albert Roso-Llorach aroso@idiapjgol.org Cristina Vedia cvedia.bnm.ics@gencat.cat Concepció Violan cviolan@idiapjgol.org Rosa Morros rmorros@idiapjgol.org 1 Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes 587, àtic, 08007 Barcelona, Spain 2 Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain 3 Institut Català de la Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain 4 Unitat de Farmàcia, Servei d’Atenció Primària Barcelonès Nord i Maresme, Institut Català de la Salut, Badalona, Spain 5 UICEC IDIAP Jordi Gol, Plataforma SCReN, Barcelona, Spain