Abstract
This chapter examines the data on costs of cardiovascular care for women and highlights the importance of chest pain and the burden of persistent angina as driving higher costs of care. For women, a consistent body of evidence reports that women (generally) utilize more healthcare resources than men. A large component of the costs of care includes those for ongoing symptoms including the burden of angina. Within the NIH-NHLBI Women’s Ischemia Syndrome Evaluation (WISE) study, costs of care were estimated for symptomatic women with and without obstructive coronary artery disease. Even women with none to mild non-obstructive coronary artery disease had predicted lifetime costs of cardiovascular care of approximately 750,000 US dollars and this amount increased for women with coronary artery disease. The economic burden of angina, even in the setting of nonobstructive CAD, is costly and can result in high lifetime costs of care. Physicians should consider the intensity of resources required to adequately care for women with angina including the financial burden of family household resources.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Agency for Healthcare Research and Quality. Medical expenditure panel survey. http://www.meps.ahrq.gov/mepsweb (2009). Last accessed 1 Aug 2012.
Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Greenlund KJ, Hailpern SM, Heit JA, Ho PM, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, McDermott MM, Meigs JB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Rosamond WD, Sorlie PD, Stafford RS, Turan TN, Turner MB, Wong ND, Wylie-Rosett J, American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18–209.
Lucas FL, DeLorenzo MA, Siewers AE, Wennberg DE. Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993–2001. Circulation. 2006;113(3):374–9.
Shugarman LR, Campbell DE, Bird CE, Gabel J, Louis AT, Lynn J. Differences in medicare expenditures during the last 3 years of life. J Gen Int Med. 2004;19:127–35.
Birnbaum H, Leong S, Kabra A. Lifetime medical costs for women: cardiovascular disease, diabetes, and stress urinary incontinence. Womens Health Issues. 2003;13:204–13.
Mathers CD, Sadana R, Salomon JA, et al. Estimates of DALE for 191 countries methods and results. World Health Organization. www.who.int/health-systems-performance/docs/article/paper16a.pdf (2000). Last accessed 1 Aug 2012.
Economic Costs. World Health Organization. http://www.who.int/cardiovascular_diseases/en/cvd_atlas_17_economics.pdf (2000). Last accessed 1 Aug 2012.
Shaw LJ, Merz CN, Pepine CJ, Reis SE, Bittner V, Kip KE, Kelsey SF, Olson M, Johnson BD, Mankad S, Sharaf BL, Rogers WJ, Pohost GM, Sopko G, Women’s Ischemia Syndrome Evaluation (WISE) Investigators. The economic burden of angina in women with suspected ischemic heart disease: results from the National Institutes of Health – National Heart, Lung, and Blood Institute – sponsored Women’s Ischemia Syndrome Evaluation. Circulation. 2006;114(9):894–904.
Shaw LJ, Merz CN, Bittner V, Kip K, Johnson BD, Reis SE, Kelsey SF, Olson M, Mankad S, Sharaf BL, Rogers WJ, Pohost GM, Sopko G, Pepine CJ, WISE Investigators. Importance of socioeconomic status as a predictor of cardiovascular outcome and costs of care in women with suspected myocardial ischemia. Results from the National Institutes of Health, National Heart, Lung and Blood Institute-sponsored Women’s Ischemia Syndrome Evaluation (WISE). J Womens Health (Larchmt). 2008;17(7):1081–92.
Stroupe KT, Teal EY, Tu W, Weiner M, Murray MD. Association of refill adherence and health care use among adults with hypertension in an urban health care system. Pharmacotherapy. 2006;26:779–89.
Banthin JS, Bernard DM. Changes in financial burdens for health care. JAMA. 2006;296:2712–19.
Angell M. Privilege and health: what’s the connection? New Eng J Med. 1993;329:126–7.
National Center for Health Statistics. Health, United States, 1998 with socioeconomic status and health chartbook.. http://www.cdc.gov/nchs/data/hus/hus98.pdf (1998). Last accessed 1 Aug 2012.
Adler NE, Boyce T, Chesney MA, Folkman S, Syme SL. SocioÂeconomic inequalities in health: no easy solution. JAMA. 1993;269:3140–5.
U.S. Social Security Administration: Office of Policy. Income of the population 55 or Older, http://www.ssa.gov/policy/docs/statcomps/income_pop55/2002/sect3.html#table 3.1 (2002). Last accessed on 1 Aug 2012.
Backlund E, Sorlie PD, Johnson NJ. A comparison of the relationships of education and income with mortality. Soc Sci Med. 1999;49(10):1373–84.
Reid FDA, Cook DG, Whincup PH. Use of statins in the secondary prevention of coronary heart disease: is treatment equitable? Heart. 2002;88:15–9.
Feder G, Crook AM, Magee P, Banerjee S, Timmis AD, Hemingway H. Ethnic differences in invasive management of coronary disease: prospective cohort study of patients undergoing coronary angiography. BMJ. 2002;324:511–16.
Ford ES, Cooper RS. Racial/ethnic differences in health care utilization of cardiovascular procedures: a review of the evidence. Health Serv Res. 1995;30(1):237–52.
Johnson BD, Shaw LJ, Pepine CJ, Reis SE, Kelsey SF, Sopko G, Rogers WJ, Mankad S, Sharaf BL, Bittner V, Bairey Merz CN. Persistent chest pain predicts cardiovascular events in women without obstructive coronary artery disease: results from the NIH-NHLBI-sponsored Women’s Ischaemia Syndrome Evaluation (WISE) study. Eur Heart J. 2006;27(12):1408–15.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag London
About this chapter
Cite this chapter
Shaw, L.J. (2013). Healthcare Costs of Angina in Women. In: Kaski, J., Eslick, G., Bairey Merz, C. (eds) Chest Pain with Normal Coronary Arteries. Springer, London. https://doi.org/10.1007/978-1-4471-4838-8_5
Download citation
DOI: https://doi.org/10.1007/978-1-4471-4838-8_5
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-4837-1
Online ISBN: 978-1-4471-4838-8
eBook Packages: MedicineMedicine (R0)