Atrial Fibrillation Associated Costs for Stroke Hospitalizations of Medicare Beneficiaries in the Stroke Belt of the United States.

PURPOSE To estimate atrial fibrillation (AF)-associated costs for stroke hospitalizations among Medicare beneficiaries aged ≥65 years in a 11-state region called stroke belt in the United States. METHODS Using the 2010 Medicare Provider Analysis and Review File database, we analyzed costs of stroke hospitalizations conditional on presence of AF (n=226 289) after excluding those with subarachnoid hemorrhage, no information on race, or a length of stay [LOS] of 30 or more days. We employed regression analysis to estimate for defined subgroups the impact of AF on costs while controlling for major potential confounders. RESULTS The average cost of all stroke hospitalizations was $27 915. The presence of AF increased this cost by $2711 (9.4%; P<0.001). AF-associated costs were $3159, $2610, and $2197 for patients aged 65-74, 75-84, and ≥85 years, respectively (all P<0.001). Among hospitalization with a length of stay (LOS) of 14-29 days, AF increased the costs by $5888 (P<0.001). AF was not associated with higher costs for hospitalizations involving intracerebral hemorrhage. CONCLUSIONS The costs of stroke hospitalizations are high, and they are even higher if the patient has AF. Further information is needed on the costs in patients with AF who are taking anticoagulants.