Abstract
Aim
Cardiovascular diseases are a major health problem in the industrialised world. The aim of the study was to measure the course of costs after a myocardial infarction.
Subject and methods
We undertook a retrospective review of the medical, hospital and drug claims data in the database of a German statutory health insurance company covering about 5 million insured persons. The data of patients suffering from myocardial infarction were extracted by using the documented hospital ICD-10 codes during 2004 and 2005. For these patients we reviewed and summarised all the charges incurred over a 1-year period after the initial index event on the basis of weekly costs and from the third party payer's perspective.
Results
We included 15,185 patients with a primary diagnosis of MI-DRG (57.43% male patients, mean age of 71.1 ± 12.6 years). The average weekly total first-year cost of a first myocardial infarction was calculated at about 251 ± 1,077 Euros per patient. The cumulative total cost was about 13,061 ± 1,162 Euros per patient for the first year. The largest burden of the first year after myocardial infarction is due to in-patient stays. This represents approximately 80% of the total costs (about 10,505 ± 1,107 Euros per year and patient).
Conclusion
Myocardial infarction is associated with significant economic costs from the perspective of statutory health insurance. This cost burden particularly occurs within the first 2 weeks following a first myocardial infarction. For this reason, efficient management of the acute event is outstandingly important.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alpert JS, Thygesen K, Antman E, Bassand JP (2000) Myocardial infarction redefined–a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 36(3):959–969
Boden WE, Shah PK, Gupta V, Ohman EM (2008) Contemporary approach to the diagnosis and management of non-ST-segment elevation acute coronary syndromes. Prog Cardiovasc Dis 50(5):311–351
Etemad LR, McCollam PL (2005) Total first-year costs of acute coronary syndrome in a managed care setting. J Manag Care Pharm 11(4):300–306
European Commission (2002) Age Standardised Death Rate for 65 Causes of Death; Females. ECHI. European Commission Health and Consumer Protection Directorate. http://www.ec.europa.eu. Accessed 6 October 2008
Kauf TL, Velazquez EJ, Crosslin DR, Weaver WD, Diaz R, Granger CB, McMurray JJ, Rouleau JL, Aylward PE, White HD, Califf RM, Schulman KA (2006) The cost of acute myocardial infarction in the new millennium: evidence from a multinational registry. Am Heart J 151(1):206–212
Kolansky DM (2009) Acute coronary syndromes: morbidity, mortality, and pharmacoeconomic burden. Am J Manag Care 15(2 Suppl):S36–S41
Krauth C, Hessel F, Hansmeier T, Wasem J, Seitz R, Schweikert B (2005) Empirical standard costs for health economic evaluation in Germany—a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67(10):736–746
Leal J, Luengo-Fernandez R, Gray A, Petersen S, Rayner M (2006) Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J 27(13):1610–1619
Lin JC, Apple FS, Murakami MM, Luepker RV (2004) Rates of positive cardiac troponin I and creatine kinase MB mass among patients hospitalized for suspected acute coronary syndromes. Clin Chem 50(2):333–338
Liu JL, Maniadakis N, Gray A, Rayner M (2002) The economic burden of coronary heart disease in the UK. Heart 88(6):597–603
Lloyd-Jones DM, Larson MG, Beiser A, Levy D (1999) Lifetime risk of developing coronary heart disease. Lancet 353(9147):89–92
Luengo-Fernandez R, Leal J, Gray A, Petersen S, Rayner M (2006) Cost of cardiovascular diseases in the United Kingdom. Heart 92(10):1384–1389
Menzin J, Wygant G, Hauch O, Jackel J, Friedman M (2008) One-year costs of ischemic heart disease among patients with acute coronary syndromes: findings from a multi-employer claims database. Curr Med Res Opin 24(2):461–468
Murray CJ, Lopez AD (1997a) Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 349(9064):1498–1504
Murray CJ, Lopez AD (1997b) Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 349(9061):1269–1276
Rastan AJ, Thiele H, Schuler G, Mohr FW (2010) Coronary artery bypass surgery for the treatment of acute coronary syndromes. Herz 35(2):70–78
Reinhold T, Thierfelder K, Muller-Riemenschneider F, Willich SN (2009) Health economic effects after DRG-implementation–a systematic overview. Gesundheitswesen 71(5):306–312
Reinhold T, Andersohn F, Hessel F, Bruggenjurgen B, Willich SN (2010) The use of routine data of statutory health insurance (SHI) in health economic research—analysis of applicability. Gesundheitsökon Qualitätsmanage accepted
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O'Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y (2008) Heart disease and stroke statistics—2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 117(4):e25–e146
Russell MW, Huse DM, Drowns S, Hamel EC, Hartz SC (1998) Direct medical costs of coronary artery disease in the United States. Am J Cardiol 81(9):1110–1115
Sagmeister M, Gessner U, Oggier W, Horisberger B, Gutzwilller F (1997) An economic analysis of ischaemic heart disease in Switzerland. Eur Heart J 18(7):1102–1109
Taylor MJ, Scuffham PA, McCollam PL, Newby DE (2007) Acute coronary syndromes in Europe: 1-year costs and outcomes. Curr Med Res Opin 23(3):495–503
Tunstall-Pedoe H (1985) Monitoring trends in cardiovascular disease and risk factors: the WHO “Monica” project. WHO Chron 39(1):3–5
Tunstall-Pedoe H (2003) MONICA monograph and multimedia sourcebook: world’s largest study of heart disease, stroke, risk factors, and population trends 1979–2002. World Health Organization, Geneva
Wagner GS, Bahit MC, Criger D, de Luna AB, Chaitman B, Clemmensen P, Klootwijk P, Marcus FI, Pahlm O, Ohman M (2000) Moving toward a new definition of acute myocardial infarction for the 21st century: status of the ESC/ACC consensus conference. European Society of Cardiology and American College of Cardiology. J Electrocardiol 33(Suppl):57–59
World Health Organization (1976) Myocardial infarction community registers: results of a WHO international collaborative study coordinated by the Regional Office for Europe. World Health Organization Regional Office for Europe. http://whqlibdoc.who.int/euro/phie/EURO_PHIE_5.pdf. Accessed 18 November 2010
World Health Organization (2011) European Detailed Mortality Database. World Health Organization Regional Office for Europe. http://data.euro.who.int/dmdb/. Accessed 18 November 2010
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Reinhold, T., Lindig, C., N. Willich, S. et al. The costs of myocardial infarction—a longitudinal analysis using data from a large German health insurance company. J Public Health 19, 579–586 (2011). https://doi.org/10.1007/s10389-011-0420-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-011-0420-8