Twelve-month healthcare utilization and expenditures in Medicare fee-for-service patients with clinically significant mitral regurgitation

Abstract

Aim: This study sought to quantify the healthcare burden of Medicare patients with clinically significant mitral regurgitation (sMR). Materials & methods: Proxy definitions were used for sMR, including MR surgery, atrial fibrillation, pulmonary hypertension or >2 echocardiograms. Results: In this study, 11,173 patients had significant degenerative MR (sDMR); 25,402 had significant functional MR (sFMR); and 12,232 had significant uncharacterized MR (sUMR). Patients with sFMR (18,880) were more likely to be hospitalized and present to the emergency department compared with patients with sDMR (9,795) or sUMR (10,587). Annual healthcare expenditures for sMR patients were: US$29,328 for sFMR; US$17,112 for sUMR; and US$12,870 for sDMR. Conclusion: Novel therapeutic interventions merit further evaluation to reduce the substantial healthcare burden of sMR in the Medicare population.

One-Year Healthcare Utilization and Expenditures Among Patients with Clinically Significant Mitral Regurgitation in Taiwan

“…For patients with sMR, other studies have reported that those with sFMR often have more comorbidities than the other cohorts, which may be associated with higher medical care costs. However, these results were in contrast to ours [ 12 ], which showed that, although the sFMR cohort showed a high prevalence of comorbidities, its healthcare utilization and annual expenditure were actually lower than those of the sDMR cohort. Severe MR can cause HF or heart rhythm problems [ 3 ].…”

“…This may be the reason why the annual expenditure in the sDMR cohort in this study was eight times higher than that in the DMR cohort and even higher than that in the sFMR cohort. The frequency of casualty visits and hospitalizations and the LOS in this study were significantly higher than those in other studies [12,13]. These results may be due to the character of healthcare in Taiwan-the National Health Insurance scheme and low cost give patients easy access to medical care [16].…”

“…The data for this retrospective, populationbased study were acquired by accessing claims The International Classification of Diseases-10 (ICD-10) diagnosis and procedure codes were used to identify patients with MR. The design used in this study was similar to that of a study of Medicare fee-for-service patients in the USA [12]. In this current study, patients were included if they met the following criteria: (1) patients who were 18 years of age or older with at least one inpatient or two outpatient claims with MR diagnosis between January 1, 2016 and December 31, 2018; (2) those with baseline data at least 6 months before the first MR diagnosis and follow-up data at least 6 months after (landmark period); and (3) those whose healthcare utilization was measured for at least 12 months after the landmark period.…”

“…A study has shown that MR and its comorbidities impact patients’ quality of life and increase healthcare utilization [ 11 ]. Another study has found that sMR increases the complexity of the disease and is associated with a substantial healthcare burden [ 12 ]. Additionally, when comparing the three different types of severe disease—functional MR (sFMR), uncharacterized MR (sUMR), and degenerative MR (sDMR)—the annual healthcare cost was higher for patients with sFMR versus those with sUMR or sDMR [ 12 ].…”

“…Our research shows that in Taiwan, patients with sFMR were older, sicker, and presented at casualty (emergency department) more frequently than those with sDMR and sUMR. Meanwhile, patients with sDMR had the highest 12…”