Table 25-1.

Estimated Direct and Indirect Costs (in Billions of Dollars) of CVD and Stroke: United States, Average Annual 2011 to 2012

Heart Disease*StrokeHypertensive DiseaseOther Circulatory ConditionsTotal CVD
Direct costs
 Hospital inpatient stays63.48.56.212.090.1
 Hospital emergency department visits4.70.91.40.67.6
 Hospital outpatient or office-based provider visits21.21.613.46.242.4
 Home health care8.84.85.01.620.2
 Prescribed medicines10.61.419.01.832.8
 Total expenditures108.717.245.022.2193.1
Indirect costs§
 Lost productivity/mortality98.615.83.65.5123.5
Grand totals207.333.048.627.7316.6
  • Numbers do not add to total because of rounding. CVD indicates cardiovascular disease.

  • * This category includes coronary heart disease, heart failure, part of hypertensive disease, cardiac dysrhythmias, rheumatic heart disease, cardiomyopathy, pulmonary heart disease, and other or ill-defined heart diseases.

  • Costs attributable to hypertensive disease are limited to hypertension without heart disease.

  • Medical Expenditure Panel Survey healthcare expenditures are estimates of direct payments for care of a patient with the given disease provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs are not included. These estimates of direct costs do not include payments attributed to comorbidities. Total CVD costs are the sum of costs for the 4 diseases but with some duplication.

  • § The American Heart Association Statistics Committee agreed to suspend the presentation of estimates of lost productivity attributable to morbidity until a better estimating method can be developed.

  • Lost future earnings of people who died in 2011 and 2012, discounted at 3%.

  • Sources: Estimates from the Household Component of the Medical Expenditure Panel Survey of the Agency for Healthcare Research and Quality for direct costs (average annual 2011–2012).1 Indirect mortality costs are based on 2011 and 2012 counts of deaths by the National Center for Health Statistics and an estimated present value of lifetime earnings furnished for 2010 by Dr Wendy Max (Institute for Health and Aging, University of California, San Francisco, April 29, 2015) and inflated to 2011 and 2012 from change in worker compensation reported by the US Bureau of Labor Statistics.

  • All estimates prepared by Michael Mussolino, National Heart, Lung, and Blood Institute.