Impact
Burden of disease
Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. The measure used is the ‘disability adjusted life year’ (DALY). This measure combines health loss from living with illness and injury (non-fatal burden, or YLD) and dying prematurely (fatal burden, or YLL) to estimate total health loss (total burden, or DALY). The Australian Burden of Disease Study 2015 (AIHW 2019a) used information from a range of sources to quantify the fatal and non-fatal effects of these diseases.
The contribution of AF to the burden of disease has increased in recent decades:
- 3.7% of the CVD burden, and 0.65% of the total burden in 2003
- 5.6% of the CVD burden, and 0.85% of the total burden in 2011
- 6.9% of the CVD burden, and 0.94% of the total burden in 2015.
The contribution of AF to the total burden of disease increases with age—1.0% for age 65–69 years, increasing to 2.5% for age 85 and over in 2015.
Most of the contribution in 2015 was non-fatal (63%).
Between 2003 and 2015, there was a two-thirds increase in DALY burden associated with AF. The contribution of the following three ‘drivers of change over time’ has been estimated to be:
- 25% increase due to population growth
- 18% increase due to population ageing
- 22% due to the change in amount of atrial fibrillation (AIHW 2020).
Expenditure
An estimated $881 million was spent on the diagnosis and treatment of AF in 2015–16, equivalent to 8.4% of recurrent expenditure on CVD and 0.8% of recurrent expenditure on all health conditions (AIHW 2019b).
Close to two-thirds of expenditure on AF (67%) was for persons aged 65 years and over.
By area, over two thirds of allocated expenditure (69% or $609 million) was spent on hospital services. These included public hospital admitted patients ($329 million), private hospital services ($199 million), public hospital outpatients ($31 million) and public hospital emergency departments ($49 million).
Another 17% ($146 million) was spent on prescription pharmaceuticals dispensed through the Pharmaceutical Benefits Scheme.
The remaining 14% ($127 million) related to non-hospital medical services (primary care), comprising general practitioner services ($64 million), specialist services ($43 million), medical imaging ($3 million), pathology ($17 million) and allied health and other services ($1 million).
References
AIHW (Australian Institute of Health and Welfare) 2019a. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease series no. 19. Cat. no. BOD 22. Canberra: AIHW.
AIHW 2019b. Disease expenditure in Australia. Cat. no. HWE 76. Canberra: AIHW.
AIHW 2020. Australian Burden of Disease Study 2015: Interactive data on disease burden. Cat. no. BOD 24. Canberra: AIHW.