Heart Rhythm O2 (Dec 2020)

Healthcare resource utilization following ECG sensor patch screening for atrial fibrillation

  • Jill Waalen, MD, MPH,
  • Alison M. Edwards, MStat,
  • Anirudh Sanyal, BEng,
  • Robert A. Zambon, PhD,
  • Lauren Ariniello, BS,
  • Gail S. Ebner, BS,
  • Katie Baca-Motes, MBA,
  • Chureen Carter, PharmD,
  • Elise Felicione, MPH, MBA,
  • Troy Sarich, PhD,
  • Eric J. Topol, MD,
  • Steven R. Steinhubl, MD

Journal volume & issue
Vol. 1, no. 5
pp. 351 – 358

Abstract

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Background: Screening for asymptomatic, undiagnosed atrial fibrillation (AF) has the potential to allow earlier treatment, possibly resulting in prevention of strokes, but also to increase medical resource utilization. Objective: To compare healthcare utilization rates during the year following initiation of screening among participants screened for AF by electrocardiogram (ECG) sensor patch compared with a matched observational control group. Methods: A total of 1718 participants recruited from a health care plan based on age and comorbidities who were screened with an ECG patch (actively monitored group) as part of a prospective, pragmatic research trial were matched by age, sex, and CHA2DS2-VASc score with 3371 members from the same health plan (observational control group). Healthcare utilization, including visits, prescriptions, procedures, and diagnoses, during the 1 year following screening was compared between the groups using health plan claims data. Results: Overall, the actively monitored group had significantly higher rates of cardiology visits (adjusted incidence rate ratio [aIRR] [95% confidence interval (CI)]: 1.43 [1.27, 1.60]), no difference in primary care provider visits (aIRR [95% CI]: 1.0 [0.95, 1.05]), but lower rates of emergency department (ED) visits and hospitalizations (aIRR [95% CI]: 0.80 [0.69, 0.92]) compared with controls. Among those with newly diagnosed AF, the reduction in ED visits and hospitalizations was even greater (aIRR [95% CI]: 0.27 [0.17, 0.43]). Conclusion: AF screening in an asymptomatic, moderate-risk population with an ECG patch was associated with an increase in cardiology outpatient visits but also significantly lower rates of ED visits and hospitalizations over the 1 year following screening.

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