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The European Journal of Health Economics

, Volume 11, Issue 5, pp 449–455 | Cite as

Expenditures of the German statutory health insurance system for patients suffering from acute coronary syndrome and treated with percutaneous coronary intervention

  • Heiko FriedelEmail author
  • Anne Delges
  • Johannes Clouth
  • Dana T. Trautvetter
Original Paper

Abstract

Patients with acute coronary syndrome (ACS) are in need of cost-intensive treatment involving different aspects of the German Health System. Percutaneous coronary intervention (PCI) is the treatment of choice for a large proportion of cases. In the present study, an analysis of the cost impact of ACS with focus on PCI therapy was conducted across-the-board for the German Health System. Results indicated that 85% of all costs arising from treatment of ACS with a trial of PCI are due to in-patient care. Projection of results onto the entire insurant collective of the statutory health system estimated a total of €954,995,603—a proportional 0.7% of all expenditure by statutory health insurances in 2005.

Keywords

Acute coronary syndrome Myocardial infarction Percutaneous transluminal angioplasty Cost analysis 

JEL Classification

I11 G22 

Notes

Acknowledgments

This study was supported by Lilly Deutschland GmbH and Daiichi Sankyo Co Ltd. Cooperation with company health insurance funds (BKK) made it possible to analyse health care data of insured persons.

References

  1. 1.
    Möllmann, H., Elsässer, A., Nef, H.M., et al.: Akutes Koronarsyndrom mit und ohne ST-Elevation. Herz 31, 820–826 (2006)CrossRefGoogle Scholar
  2. 2.
    Hamm, C.W.: Leitlinien: Akutes Koronarsyndrom (ACS) Teil 1: ACS ohne persistierende ST-Hebung. Z. Kardiol. 93, 72–90 (2004)CrossRefGoogle Scholar
  3. 3.
    Hamm, C.W.: Leitlinien: Akutes Koronarsyndrom (ACS) Teil 2: Akutes Koronarsyndrom mit ST-Hebung. Z. Kardiol. 93, 324–341 (2004)CrossRefGoogle Scholar
  4. 4.
    German Census Bureau: Ergebnisse der Todesursachenstatistik für Deutschland ausführliche vierstellige ICD10-Klassifikation. Wiesbaden (2007)Google Scholar
  5. 5.
    Silber, S., Albertsson, A., Avilés, F.F.: Guidelines for percutaneous coronary interventions. Eur. Heart J. 26, 804–847 (2005)CrossRefGoogle Scholar
  6. 6.
    Bassand, J.P., Hamm, C.W., Ardissino, D., et al.: Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur. Heart J. 28, 1598–1660 (2007)CrossRefGoogle Scholar
  7. 7.
    Murray, C.J.L., Lopez, Z.D.: Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 349(9064), 1498–1504 (1997)CrossRefGoogle Scholar
  8. 8.
    Van de Werf, F., Bax, J., Betriu, A., et al.: Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. Eur. Heart J. 29, 2909–2945 (2008)CrossRefGoogle Scholar
  9. 9.
    Zhang, Z., Spertus, J.A., Mahoney, E.M., et al.: The impact of acute coronary syndrome on clinical, economic, and cardiac-specific health status after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: 1-year results from the stent or surgery (SoS) trial. Am. Heart J. 150(1), 175–181 (2005)CrossRefGoogle Scholar
  10. 10.
    Taylor, M., Scuffham, P.A., McCollam, P.L., Newby, D.E.: Acute coronary syndromes in Europe: 1-year costs and outcomes. Curr. Med. Res. Opin. 23(3), 495–503 (2007)CrossRefGoogle Scholar
  11. 11.
    Etemad, L.R., McCollam, P.L.: Total first-year costs of acute coronary syndrome in a managed care setting. J. Manag. Care Pharm. 11(4), 300–306 (2005)Google Scholar
  12. 12.
    Giersiepen, M.P.H., Pohlabeln. H., Egidi, G., Pigeot I.: Die ICD-Kodierqualität für Diagnosen in der ambulanten Versorgung. Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz. 50, 1028–1038 (2007)Google Scholar
  13. 13.
    German Institute for Medical Documentation (DIMDI): ICD-10-GM. Videel, Cologne (2003)Google Scholar
  14. 14.
    German Institute for Medical Documentation (DIMDI): Operationen- und Prozedurenschlüssel, Internationale Prozeduren in der Medizin. http://www.dimdi.de/static/de/klassi/prozeduren/ops301/opshtml2007/fr-ops.htm (2005). Accessed 16 Jan 2008
  15. 15.
    Federal Association of panel doctors (KBV): Einheitlicher Bewertungsmaßstab. Deutscher Ärzte-Verlag, Cologne (2001)Google Scholar
  16. 16.
    Filler, G., Hermanns, P.M.: EBM2000plus. Ebner & Spiegel, Munich (2005)Google Scholar
  17. 17.
    Tschöpe, D., Stratmann, B., Standl, E., et al.: Diagnostik und Therapie von Herzerkrankungen bei Diabetes mellitus. In: Scherbaum W.A., Kerner W. (eds.) Evidenzbasierte Leitlinie der Deutschen Diabetes-Gesellschaft (DDG). http://www.deutsche-diabetes-gesellschaft.de/leitlinien/EBL_Herz_Update_2006.pdf (2006). Accessed 10 June 2008
  18. 18.
    Wittchen, H.-U., Glaesmer, H., März, W., et al.: Cardiovascular risk factors in primary care: methods and baseline prevalence rates—the DETECT program. Curr. Med. Res. Opin. 21(4), 619–629 (2005)CrossRefGoogle Scholar
  19. 19.
  20. 20.
    BKK Bundesverband: Gesundheitsreport 2006, Demografischer und wirtschaftlicher Wandel—gesundheitliche Folgen. Essen (2006)Google Scholar
  21. 21.
    Fricke, G., Günther, J., Zawinell, A.: ATC-Index mit DDD-Angaben für den deutschen Arzneimittelmarkt. WIdO, Bonn (2007)Google Scholar
  22. 22.
    Dijksman, L.M., Hirsch, A., Winhausen, F., Asselman, F.F.: Cost effectiveness of early versus selectively invasive strategy in patients with acute coronary syndromes without ST-segment elevation. Int. J. Cardiol. 131(2), 204–211 (2009)CrossRefGoogle Scholar
  23. 23.
    Epstein, D.M., Sculpher, M.J., Clayton, T.C., et al.: Costs of an early intervention versus a conservative strategy in acute coronary syndrome. Int. J. Cardiol. 127(2), 240–246 (2008)CrossRefGoogle Scholar
  24. 24.
    Bramkamp, M., Radovanovic, D., Erne, P., Szucs, T.D.: Determinants of costs and the length of stay in acute coronary syndromes: a real life analysis of more than 10 000 patients. Cardiovasc. Drugs Ther. 21, 389–398 (2007)CrossRefGoogle Scholar
  25. 25.
    Fricke, F.U., Silber, S.: Können Medikamente frei setzende Koronarstents eine Bypassoperation ersetzen? Herz 30(4), 332–338 (2005)CrossRefGoogle Scholar
  26. 26.
    Bundesärztekammer (BÄK), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Kassenärztliche Bundesvereinigung (KBV). Nationales Programm für Versorgungs-Leitlinien. Nationale Versorgungs-Leitlinie Chronische KHK. Kurzfassung, Version 1.8. http://www.khk.versorgungsleitlinien.de (2008). Accessed 25 June 2009
  27. 27.

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Heiko Friedel
    • 1
    Email author
  • Anne Delges
    • 1
  • Johannes Clouth
    • 2
  • Dana T. Trautvetter
    • 1
  1. 1.Institut für Prävention und Gesundheitsförderung an der Universität Duisburg-EssenEssenGermany
  2. 2.Department of Health Care RelationsLilly Deutschland GmbHBad HomburgGermany

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