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.