OBJECTIVES : Mitral regurgitation (MR) is a type of heart valve disease, which is characterized by systolic blood flow reversal from the left ventricle to the left atrium. In Taiwan, little data is available in describing the clinical characteristics, treatment patterns, and economic burden in patients with sMR. We aim to quantify the impact of sMR on Taiwan’s healthcare system.

METHODS : National Health Insurance Research Database (NHIRD) is a nationally representative cohort that contains detailed registry and claims data from all 23 million residents of Taiwan. With this database, we conducted a retrospective cohort study to identify patients with sMR, including MR surgery, atrial fibrillation, pulmonary hypertension or >2 echocardiograms. We follow-up these sMR patients for 12-month period and classified into three cohorts based on their disease etiology: functional MR (sFMR, N=2,643), degenerative MR (sDMR, N=252), and uncharacterized MR (sUMR, N=1,706) during year 2016-2018.

RESULTS : Patients with sFMR were older than sDMR and sUMR (age at diagnosis was 72.5, 61.1, and 68.8, respectively). Patients with sDMR were more likely to be female than sFMR and sUMR (54.6%, 50.4%, 48.4%). In terms of Charlson comorbidity index, patients with sFMR had the highest score (3.22) when compared with sDMR (1.77) and sUMR (1.59). Moreover, sDMR patients were more likely to be hospitalized compared with patients with sFMR or sUMR. Patients with sFMR were more likely to be present to the emergency department compared with sDMR or sUMR. The annual healthcare expenditures for sMR patients were: USD $20,033 for sDMR, US$11,480 for sFMR and US$5,451 for sUMR.

CONCLUSIONS : In Taiwan, patients with sFMR were older, sicker, and presented at the emergency room more frequently than patients with sDMR and sUMR. While patients with sDMR had the highest 12-month healthcare expenditures across cohorts. The finding is not consistent what has been shown in the US, which warrant further investigation