Hodgson T A, Cohen A J
Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
Med Care. 1999 Oct;37(10):994-1012. doi: 10.1097/00005650-199910000-00004.
Circulatory system diseases are a significant burden in terms of morbidity, mortality, and use of health care services. This article presents total, per capita, and per condition US medical care expenditures in 1995 for circulatory diseases according to sex, age, and type of health service.
Total personal health care expenditures estimated by the Health Care Financing Administration for each type of health care service are separated into components to estimate patient expenditures by age, sex, primary medical diagnosis, and health care service for all diseases of the circulatory system, heart disease, coronary heart disease, congestive heart failure, hypertensive disease, and cerebrovascular disease.
Expenditures for circulatory diseases totaled $127.8 billion in 1995 (17% of all personal health care expenditures), $486 per capita, and $1,636 per condition. Approximately one half of expenditures was for hospital care and 20% was for nursing home care. Heart disease accounted for 60% of circulatory expenditures. Expenditures increased with age and reached 35% of expenditures among persons aged 85 years and older, which was almost $7,000 per capita. These relationships vary somewhat according to the specific circulatory disease, type of health care, and age.
Expenditures increase with age and circulatory diseases can be expected to command an increasing share of national health expenditures as the number and proportion of the population that is elderly grows. The alteration of lifestyles and medical interventions provide many opportunities to prevent circulatory diseases and to reduce national health expenditures.
循环系统疾病在发病率、死亡率以及医疗服务使用方面都是一项重大负担。本文呈现了1995年美国按性别、年龄和医疗服务类型划分的循环系统疾病的总医疗费用、人均医疗费用以及每种疾病的医疗费用。
医疗保健财务管理局估算的各类医疗服务的个人医疗总费用被细分为不同组成部分,以估算所有循环系统疾病、心脏病、冠心病、充血性心力衰竭、高血压疾病和脑血管疾病按年龄、性别、主要医疗诊断和医疗服务划分的患者费用。
1995年循环系统疾病的费用总计1278亿美元(占所有个人医疗费用的17%),人均486美元,每种疾病1636美元。大约一半的费用用于医院护理,20%用于疗养院护理。心脏病占循环系统疾病费用的60%。费用随年龄增长而增加,85岁及以上人群的费用占总费用的35%,人均近7000美元。这些关系因具体的循环系统疾病、医疗服务类型和年龄而有所不同。
费用随年龄增长而增加,随着老年人口数量和比例的增加,循环系统疾病预计将在国家医疗费用中占据越来越大的份额。生活方式的改变和医疗干预为预防循环系统疾病和降低国家医疗费用提供了许多机会。