Results
Overall prevalence based on integrated medical and pharmacy claims was
12.7% in the elderly and 0.94% in those age < 65 (table 1a),
with males having higher prevalence (14.8% for Medicare and 1.2% for
commercial) than females (11.2% for Medicare and 0.64% for
Commercial). Anticoagulants, office visits, and combined medicalunderestimated AF prevalence in the younger and elderly
populations by up to 50% (table 1a). The degree of prevalence
underestimation was much higher in the younger cohort relative to the
elderly population. The overall prevalence of AF was 2.2%, with males
having higher prevalence (2.5%) than females (1.9%). One should note
that the prevalence ratios for elderly females relative to younger
females was 17.29 (95%CI 17.29-17.81), a value that is higher than for
elderly males (11.91 (95%CI 11.73-12.09)). Collectively, older females
were at 50% higher risk for prevalent AF than the older males.
When individual medical and pharmacy services were assessed using
combined medical and pharmacy criteria, office visits captured the
highest scores (61%) for Medicare followed by anticoagulants (51.2%)
(Table 1b). For commercial, the trend was opposite with anticoagulant
scoring 53.5% followed by 44.6% for office visits. ER and hospital
admission scores were lower than office visits and anticoagulants
(23.3% and 6.8%, respectively for the Medicare population; and much
lower for the commercial cohort, 1.3% and 0.5%, respectively).
Procedures yielded higher prevalence targets in the younger population
than the elderly (7-8% for commercial relative to 2% to 5% for
Medicare). Office observation was higher in Medicare (8.6%) than
Commercial (5.3%). Rhythm control resulted in higher values for
Commercial (15.2%) than Medicare (11.6%). Combined medical criteria
yielded slightly higher values than office visits.