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Cost of cardiovascular diseases in the United Kingdom

Cost of cardiovascular diseases in the United Kingdom. Claudia Soiland-Reyes Journal Club 28 th November 2012. Paper: Heart 2006, Cost of cardiovascular diseases in the United Kingdom. Luengo-Fernández , R., Leal, J., Gray , A., Pettersen , S. and Rayner , M.

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Cost of cardiovascular diseases in the United Kingdom

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  1. Cost of cardiovascular diseases in the United Kingdom Claudia Soiland-Reyes Journal Club 28th November 2012

  2. Paper: Heart 2006, Cost of cardiovascular diseases in the United Kingdom. Luengo-Fernández, R., Leal, J., Gray, A., Pettersen, S. and Rayner, M. • Objective: “To estimate the economic burden of cardiovascular disease (CVD) in the United Kingdom, including health and non-healthcare costs, and the proportion of total CVD cost due to coronary heart disease (CHD) and cerebrovascular disease.”

  3. Study characteristics • Cost-of-illness • Prevalence-based approach (All UK residents in 2004 with CVD and subgroups) • Societal perspective • Top-down approach to calculate total expenditure based on aggregate data on morbidity, mortality, resource use and disease-related costs.

  4. Healthcare expenditure • Healthcare expenditure • Community health and social services (England figures adjusted to UK) • Primary care (CVD consultation rates from national survey) • Accident and Emergency care (HES) • Hospital day cases (HES) • Inpatient care (product of average length of stay, no. CVD discharges) • Cardiac rehabilitation services (proportion of CVD hospitalisations) • Outpatient care (CVD attendances) • Drugs ( CHD and cerebrovascular proportions estimated using France, Germany and Netherlands proportions)

  5. Non-healthcare costs • Informal care – Opportunity cost of unpaid care. • Informal care time of carers in retirement or not in employment was valued on the basis of minimum wages – but it’s not clear how do they estimate this proportion. • Only considering costs in current year but not future losses as in productivity losses • Productive losses arising from morbidity and premature death • Total morbidity loss calculated based on the “friction period” estimated to be 90 days, but mortality costs calculated across all the premature years.

  6. Total cost of CVD: £29.1 billion • CHD: 29% - £8.5 billion • Cerebrovascular disease: 27% - £8 billion • Other CVD diseases: 44% • Healthcare costs: 60% • Productivity losses: 23% • Informal care-related costs: 17%

  7. Points for discussion • Extrapolation of figures • UK estimations extrapolated based on population ratios! However CHD prevalence rates are higher in Scotland • Different national guidelines that imply different healthcare costs • Cost to society • Friction period for productivity losses due to morbidity but not for mortality • Informal care costs calculated based on wages and not salaries. • Don’t know of a more recent national estimate • Reference costs were not published back then, figures could be updated

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