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Long-term healthcare use and costs in patients with stable coronary artery disease: A population-based cohort using linked health records (CALIBER)

Walker, Simon, Asaria, Miqdad ORCID: 0000-0002-3538-4417, Manca, Andrea, Palmer, Stephen, Gale, Chris P., Shah, Anoop Dinesh, Abrams, Keith R., Crowther, Michael, Timmis, Adam, Hemingway, Harry and Sculpher, Mark (2016) Long-term healthcare use and costs in patients with stable coronary artery disease: A population-based cohort using linked health records (CALIBER). European Heart Journal - Quality of Care and Clinical Outcomes, 2 (2). pp. 125-140. ISSN 2058-5225

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Identification Number: 10.1093/ehjqcco/qcw003

Abstract

Aims To examine long-term healthcare utilization and costs of patients with stable coronary artery disease (SCAD). Methods and results Linked cohort study of 94 966 patients with SCAD in England, 1 January 2001 to 31 March 2010, identified from primary care, secondary care, disease, and death registries. Resource use and costs, and cost predictors by time and 5-year cardiovascular disease (CVD) risk profile were estimated using generalized linear models. Coronary heart disease hospitalizations were 20.5% in the first year and 66% in the year following a non-fatal (myocardial infarction, ischaemic or haemorrhagic stroke) event. Mean healthcare costs were £3133 per patient in the first year and £10 377 in the year following a non-fatal event. First-year predictors of cost included sex (mean cost £549 lower in females), SCAD diagnosis (non-ST-elevation myocardial infarction cost £656 more than stable angina), and co-morbidities (heart failure cost £657 more per patient). Compared with lower risk patients (5-year CVD risk 3.5%), those of higher risk (5-year CVD risk 44.2%) had higher 5-year costs (£23 393 vs. £9335) and lower lifetime costs (£43 020 vs. £116 888). Conclusion Patients with SCAD incur substantial healthcare utilization and costs, which varies and may be predicted by 5-year CVD risk profile. Higher risk patients have higher initial but lower lifetime costs than lower risk patients as a result of shorter life expectancy. Improved cardiovascular survivorship among an ageing CVD population is likely to require stratified care in anticipation of the burgeoning demand.

Item Type: Article
Divisions: LSE Health
Date Deposited: 31 Jul 2019 09:54
Last Modified: 20 Sep 2021 00:36
URI: http://eprints.lse.ac.uk/id/eprint/101264

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