Abstract 4140643: Real World Evidence on Health Care Resources Utilization and Economic Burden of Arrhythmias in Patients with Diabetes and COPD.

Introduction: We studied the healthcare resource utilization (HCRU) and medical costs of managing arrhythmias inT2D and COPD, and the impact of EKG screening on the rate of hospitalization and ER visits. Hypothesis: Arrhythmias in T2D and COPD generate high costs. Screening with EKG monitoring devices may be associated with a reduced rate of hospitalization and ER visits for arrhythmias. Methods: A retrospective claims analysis using the Merative MarketScan and the Symphony Integrated Dataverse databases. We identified patients > 18 years with claims for T2D or COPD or both T2D and COPD (T2D+COPD) and assigned them into groups: Target: patients without prior history of arrythmias, followed by arrythmias claims. Control: patients with either of the conditions, but without arrhythmias claims. Target and control were matched 1:1 on demographic, year of first episode of arrhythmia, risk (ECI, DSI, Gold criteria). HCRU and medical cost drivers over 24 months were analyzed. HCRU of patients with arrythmia screened with EKG monitoring devices was compared to that of not screened patients. Results: Target group and control group included the same number of patients.213,226 T2D: 47,851 COPD; 31,571T2D/COPD. Atrial fibrillation was the most reported arrhythmia in the target cohort, followed by SVT. Hospitalizations/1000/year were: 584/205 (T2D target/control); 650/311(COPD target/control); 844/402 (T2D+COPD). The ER days/1000 /year and the 30 days readmissionfor the target patients were nearly twice as high than for the control. Total cost of care per patient / year was significantly higher for all target patients compared to control (T2D $34,171/ $18,687; COPD $ 37,719/$25,656; T2D COPD $46,484/ $30,802). The per patient / year cost of hospitalization was higher in the target patient's vs control (T2D $28,316/$19,439; COPD $25,098/$17,906; T2D COPD $28,694/$19,352). ER cost per patient/year was 35%-50% higher in the target cohort. Hospitalizations/1000 /month of patients screened with monitor devices was significantly lower than a 1:1 matched control cohort not using monitoring devices (T2D 64/215; COPD 69/198; 93/276). ER visits/1000/year were up to 50% lower in patients screened with monitoring devices. Conclusions: Arrhythmias significantly increase HCRU and total cost for T2D and COPD, particularly in patients requiring ER visits and hospitalization. Early detection with monitoring devices, could reduce the utilization of acute care and associated costs.