Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015

Daehoon Kim, Pil Sung Yang, Eunsun Jang, Hee Tae Yu, Tae Hoon Kim, Jae Sun Uhm, Jong Youn Kim, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung, Gregory Y.H. Lip

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: Temporal changes in the healthcare burden of atrial fibrillation (AF) are less well known in rapidly ageing Asian countries. We examined trends in hospitalisations, costs, treatment patterns and outcomes related to AF in Korea. Methods: Using the National Health Insurance Service (NHIS) database involving the entire adult Korean population (n=41 701 269 in 2015), we analysed a nationwide AF cohort representing 931 138 patients with AF. We studied all hospitalisations due to AF from 2006 to 2015. Results: Overall, hospitalisations for AF increased by 420% from 767 to 3986 per 1 million Korean population from 2006 to 2015. Most admissions occurred in patients aged ≥70 years, and the most frequent coexisting conditions were hypertension, heart failure and chronic obstructive pulmonary disease. Hospitalisations mainly due to major bleeding and AF control increased, whereas hospitalisations mainly due to ischaemic stroke and myocardial infarction decreased. The total cost of care increased even after adjustment for inflation from €68.4 million in 2006 to €388.4 million in 2015, equivalent to 0.78% of the Korean NHIS total expenditure. Overall in-hospital mortality decreased from 7.5% in 2006 to 4.3% in 2015. The in-hospital mortality was highest in patients ≥80 years of age (7.7%) and in patients with chronic kidney disease (7.4%). Conclusions: AF hospitalisations have increased exponentially over the past 10 years in Korea, in association with an increase in comorbid chronic diseases. Mortality associated with AF hospitalisations decreased during the last decade, but hospitalisation costs have markedly increased.

Original languageEnglish
JournalHeart
DOIs
Publication statusAccepted/In press - 2018 Apr 17

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Korea
Atrial Fibrillation
Hospitalization
National Health Programs
Hospital Mortality
Costs and Cost Analysis
Economic Inflation
Health Expenditures
Chronic Renal Insufficiency
Chronic Obstructive Pulmonary Disease
Population
Chronic Disease
Heart Failure
Stroke
Myocardial Infarction
Databases
Hemorrhage
Hypertension
Delivery of Health Care
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, D., Yang, P. S., Jang, E., Yu, H. T., Kim, T. H., Uhm, J. S., ... Lip, G. Y. H. (Accepted/In press). Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015. Heart. https://doi.org/10.1136/heartjnl-2017-312930
Kim, Daehoon ; Yang, Pil Sung ; Jang, Eunsun ; Yu, Hee Tae ; Kim, Tae Hoon ; Uhm, Jae Sun ; Kim, Jong Youn ; Pak, Hui Nam ; Lee, Moon Hyoung ; Joung, Boyoung ; Lip, Gregory Y.H. / Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015. In: Heart. 2018.
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abstract = "Objective: Temporal changes in the healthcare burden of atrial fibrillation (AF) are less well known in rapidly ageing Asian countries. We examined trends in hospitalisations, costs, treatment patterns and outcomes related to AF in Korea. Methods: Using the National Health Insurance Service (NHIS) database involving the entire adult Korean population (n=41 701 269 in 2015), we analysed a nationwide AF cohort representing 931 138 patients with AF. We studied all hospitalisations due to AF from 2006 to 2015. Results: Overall, hospitalisations for AF increased by 420{\%} from 767 to 3986 per 1 million Korean population from 2006 to 2015. Most admissions occurred in patients aged ≥70 years, and the most frequent coexisting conditions were hypertension, heart failure and chronic obstructive pulmonary disease. Hospitalisations mainly due to major bleeding and AF control increased, whereas hospitalisations mainly due to ischaemic stroke and myocardial infarction decreased. The total cost of care increased even after adjustment for inflation from €68.4 million in 2006 to €388.4 million in 2015, equivalent to 0.78{\%} of the Korean NHIS total expenditure. Overall in-hospital mortality decreased from 7.5{\%} in 2006 to 4.3{\%} in 2015. The in-hospital mortality was highest in patients ≥80 years of age (7.7{\%}) and in patients with chronic kidney disease (7.4{\%}). Conclusions: AF hospitalisations have increased exponentially over the past 10 years in Korea, in association with an increase in comorbid chronic diseases. Mortality associated with AF hospitalisations decreased during the last decade, but hospitalisation costs have markedly increased.",
author = "Daehoon Kim and Yang, {Pil Sung} and Eunsun Jang and Yu, {Hee Tae} and Kim, {Tae Hoon} and Uhm, {Jae Sun} and Kim, {Jong Youn} and Pak, {Hui Nam} and Lee, {Moon Hyoung} and Boyoung Joung and Lip, {Gregory Y.H.}",
year = "2018",
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Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015. / Kim, Daehoon; Yang, Pil Sung; Jang, Eunsun; Yu, Hee Tae; Kim, Tae Hoon; Uhm, Jae Sun; Kim, Jong Youn; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung; Lip, Gregory Y.H.

In: Heart, 17.04.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015

AU - Kim, Daehoon

AU - Yang, Pil Sung

AU - Jang, Eunsun

AU - Yu, Hee Tae

AU - Kim, Tae Hoon

AU - Uhm, Jae Sun

AU - Kim, Jong Youn

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

AU - Lip, Gregory Y.H.

PY - 2018/4/17

Y1 - 2018/4/17

N2 - Objective: Temporal changes in the healthcare burden of atrial fibrillation (AF) are less well known in rapidly ageing Asian countries. We examined trends in hospitalisations, costs, treatment patterns and outcomes related to AF in Korea. Methods: Using the National Health Insurance Service (NHIS) database involving the entire adult Korean population (n=41 701 269 in 2015), we analysed a nationwide AF cohort representing 931 138 patients with AF. We studied all hospitalisations due to AF from 2006 to 2015. Results: Overall, hospitalisations for AF increased by 420% from 767 to 3986 per 1 million Korean population from 2006 to 2015. Most admissions occurred in patients aged ≥70 years, and the most frequent coexisting conditions were hypertension, heart failure and chronic obstructive pulmonary disease. Hospitalisations mainly due to major bleeding and AF control increased, whereas hospitalisations mainly due to ischaemic stroke and myocardial infarction decreased. The total cost of care increased even after adjustment for inflation from €68.4 million in 2006 to €388.4 million in 2015, equivalent to 0.78% of the Korean NHIS total expenditure. Overall in-hospital mortality decreased from 7.5% in 2006 to 4.3% in 2015. The in-hospital mortality was highest in patients ≥80 years of age (7.7%) and in patients with chronic kidney disease (7.4%). Conclusions: AF hospitalisations have increased exponentially over the past 10 years in Korea, in association with an increase in comorbid chronic diseases. Mortality associated with AF hospitalisations decreased during the last decade, but hospitalisation costs have markedly increased.

AB - Objective: Temporal changes in the healthcare burden of atrial fibrillation (AF) are less well known in rapidly ageing Asian countries. We examined trends in hospitalisations, costs, treatment patterns and outcomes related to AF in Korea. Methods: Using the National Health Insurance Service (NHIS) database involving the entire adult Korean population (n=41 701 269 in 2015), we analysed a nationwide AF cohort representing 931 138 patients with AF. We studied all hospitalisations due to AF from 2006 to 2015. Results: Overall, hospitalisations for AF increased by 420% from 767 to 3986 per 1 million Korean population from 2006 to 2015. Most admissions occurred in patients aged ≥70 years, and the most frequent coexisting conditions were hypertension, heart failure and chronic obstructive pulmonary disease. Hospitalisations mainly due to major bleeding and AF control increased, whereas hospitalisations mainly due to ischaemic stroke and myocardial infarction decreased. The total cost of care increased even after adjustment for inflation from €68.4 million in 2006 to €388.4 million in 2015, equivalent to 0.78% of the Korean NHIS total expenditure. Overall in-hospital mortality decreased from 7.5% in 2006 to 4.3% in 2015. The in-hospital mortality was highest in patients ≥80 years of age (7.7%) and in patients with chronic kidney disease (7.4%). Conclusions: AF hospitalisations have increased exponentially over the past 10 years in Korea, in association with an increase in comorbid chronic diseases. Mortality associated with AF hospitalisations decreased during the last decade, but hospitalisation costs have markedly increased.

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U2 - 10.1136/heartjnl-2017-312930

DO - 10.1136/heartjnl-2017-312930

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JF - Heart

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