Abstract 1284: Medical Care Costs Among Patients With Established Cardiovascular Disease
Background: Patients with cardiovascular disease (CVD) incur over twice the medical costs of age and sex-matched patients without CVD. However, specific estimates of medical costs among patients with established CVD are scant. We sought to estimate the annual medical costs incurred over a period of up to seven years.
Methods: We identified 12,278 patients who were added to the Kaiser Permanente Northwest CVD registry in the years 2000–2005. We followed patients until they died, left the health plan, or until June 30, 2008. Direct medical costs were calculated over an individual’s entire follow-up period (in 2008 dollars) and annualized by dividing by months of follow-up. We compared age/sex-adjusted costs for patients with and without conditions known to be associated with medical costs, such as diabetes and chronic kidney disease, and CVD risk factors including obesity, hypertension, hyperlipidemia, and history of smoking.
Results: Total mean annual per-person medical costs were $18,953±39,036. Inpatient costs accounted for 43% ($8,114±25,410) of total costs. Patients who experienced a secondary CVD hospitalization had significantly higher mean annual costs than those who did not ($62,754 vs. $13,509, p<.0001). Other large cost differences were found in comparisons of patients with and without diabetes ($27,258 vs. $17,210, p<0001), chronic kidney disease defined as GFR <60mil/min ($29,498 vs. $16,326), depression ($26,681 vs. $17,303, p<.0001), and death ($28,689 vs. $17,778, p<.0001).
Conclusions: The American Heart Association estimates that ~22 million US residents have prevalent CHD or stroke. Applying our cost estimates suggests that nationwide direct medical costs total over 400 billion for these individuals. Although several comorbid conditions contributed to this burden, avoidance of secondary hospitalizations appears to be the key to substantially reducing health care consumption among patients with established CVD.