Kruse Marie, Davidsen Michael, Madsen Mette, Gyrd-Hansen Dorte, Sørensen Jan
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Scand J Public Health. 2008 Nov;36(8):850-6. doi: 10.1177/1403494808095955.
The objective of this paper is firstly to estimate the healthcare costs attributable to heart disease in Denmark using recently available data for 2002-05. Secondly, to estimate the attributable healthcare costs of lifestyle risk factors among heart patients, in order to inform decision making about prevention programmes specifically targeting patients with heart disease.
For a cohort consisting of participants in a national representative health interview survey, register-based information about hospital diagnosis was used to identify patients with heart disease. Healthcare consumption during 2002- 05 among individuals developing heart disease during 2002-05 was compared with individuals free of heart disease. Healthcare costs attributable to heart disease were estimated by linear regression with adjustment for confounding factors. The attributable costs of excess drinking, physical inactivity and smoking among future heart patients were estimated with the same method.
Individuals with heart disease cost the healthcare system on average 3,195 (p<0.0001) per person-year more than individuals without heart disease. The attributable cost of unhealthy lifestyle factors among individuals at risk of heart disease was about 11%-16% of the attributable cost of heart disease.
Heart disease incurs significant additional costs to the healthcare sector, and more so if heart patients have a history of leading an unhealthy life. Consequently, strategies to prevent or cease unhealthy lifestyle may not only result in cost savings due to avoided heart disease. Additional cost savings may be obtained because heart patients who prior to the disease led a more healthy life consume fewer healthcare resources.
本文的目的首先是利用2002 - 2005年最新可得数据估算丹麦心脏病所致的医疗费用。其次，估算心脏病患者中生活方式风险因素所致的医疗费用，以便为专门针对心脏病患者的预防项目决策提供依据。
对于一个由全国代表性健康访谈调查参与者组成的队列，利用基于登记的医院诊断信息来识别心脏病患者。将2002 - 2005年期间患心脏病的个体在2002 - 2005年期间的医疗消费与无心脏病个体进行比较。通过线性回归并对混杂因素进行调整来估算心脏病所致的医疗费用。采用相同方法估算未来心脏病患者中过量饮酒、缺乏身体活动和吸烟所致的费用。
心脏病患者使医疗系统每人每年的花费平均比无心脏病患者多3195（p<0.0001）。心脏病高危个体中不健康生活方式因素所致的费用约占心脏病所致费用的11% - 16%。
心脏病给医疗部门带来了巨大的额外费用，如果心脏病患者有不健康生活史，费用更高。因此，预防或停止不健康生活方式的策略不仅可能因避免心脏病而节省费用。由于患病前生活更健康的心脏病患者消耗的医疗资源更少，还可能获得额外的费用节省。
