The healthcare burden of disease progression in medicare patients with functional mitral regurgitation

J Med Econ. 2019 Sep;22(9):909-916. doi: 10.1080/13696998.2019.1621325. Epub 2019 Jun 7.

Abstract

Objective: This retrospective database analysis estimated the incremental effect that disease progression from non-clinically significant functional mitral regurgitation (nsFMR) to clinically significant FMR (sFMR) has on clinical outcomes and costs. Methods: Medicare Fee for Service beneficiaries with nsFMR were examined, defined as those with a heart failure diagnosis prior to MR. Patients were classified as ischemic if there was a history of: CAD, AMI, PCI, or CABG. The primary outcome was time to sFMR, defined as pulmonary hypertension, atrial fibrillation, mitral valve surgery, serial echocardiography, or death, using a Cox hazard regression model. Annualized hospitalizations, inpatient hospital days, and healthcare expenditures were also modeled. Results: Patients with IHD had higher risk (Hazard Ratio = 1.22 [1.14-1.30]) for disease progression compared to patients without. The progression cohort had significantly more annual inpatient hospitalizations (non-IHD = 1.32; IHD = 1.40) than the non-progression cohort (non-IHD = 0.36; IHD = 0.34), and significantly more annual inpatient hospital days (non-IHD = 13.07; IHD = 13.52) than the non-progression cohort (non-IHD = 2.29; with IHD = 2.08). The progression cohort had over 3.5-times higher costs vs the non-progression cohort, independent of IHD (non-IHD = $12,798 vs $46,784; IHD = $12,582 vs $49,348). Conclusion: Treating FMR patients earlier in their clinical trajectory may prevent disease progression and reduce high rates of healthcare utilization and expenditures.

Keywords: Functional mitral valve regurgitation; I10; I13; disease progression; healthcare expenditure; healthcare utilization.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Disease Progression*
  • Fee-for-Service Plans
  • Female
  • Health Expenditures
  • Hospitalization
  • Humans
  • Length of Stay
  • Male
  • Medicare / statistics & numerical data*
  • Middle Aged
  • Mitral Valve Insufficiency / economics*
  • Mitral Valve Insufficiency / physiopathology*
  • Models, Econometric
  • Residence Characteristics
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Socioeconomic Factors
  • Time Factors
  • United States