Attendance-related healthcare resource utilisation and costs in patients with Brugada Syndrome in Hong Kong: A retrospective cohort study

Background

Understanding healthcare resource utilisation and its associated costs are important for identifying areas of improvement regarding resource allocations. However, there is limited research exploring this issue in the setting of Brugada syndrome (BrS).

Methods

This was a retrospective territory-wide study of BrS patients from Hong Kong. Healthcare resource utilisation for accident and emergency (A&E), inpatient and specialist outpatient attendances were analysed over a 19-year period, with their associated costs presented in US dollars.

Results

A total of 507 BrS patients with a mean presentation age of 49.9 ± 16.3 years old were included. Of these, 384 patients displayed spontaneous type 1 electrocardiographic (ECG) Brugada pattern and 77 patients had presented with ventricular tachycardia/ventricular fibrillation (VT/VF). At the individual patient level, the median annualised costs were $110 (52-224) at the (A&E) setting, $6812 (1982-32414) at the inpatient setting and $557 (326-1001) for specialist outpatient attendances. Patients with initial VT/VF presentation had overall greater costs in inpatient ($20161 [9147-189215] vs. $5290 [1613-24937],p<0.0001) and specialist outpatient setting ($776 [438-1076] vs. $542 [293-972],p=0.015) compared to those who did not present VT. In addition, patients without Type 1 ECG pattern had greater median costs in the specialist outpatient setting ($7036 [3136-14378] vs. $4895 [2409-10554],p=0.019).

Conclusion

There is a greater healthcare demand in the inpatient and specialist outpatient settings for BrS patients. The most expensive attendance type was inpatient setting stay at $6812 per year. The total median annualised cost of BrS patients without VT/VF presentation was 78% lower compared to patients with VT/VF presentation.