Wittels E H, Hay J W, Gotto A M
Department of Internal Medicine, Baylor College of Medicine, Methodist Hospital, Houston, Texas 77030.
Am J Cardiol. 1990 Feb 15;65(7):432-40. doi: 10.1016/0002-9149(90)90806-c.
A model has been developed to determine the cost of coronary artery disease (CAD) based on the 5 primary events identified in the Framingham Study: acute myocardial infarction, angina pectoris, unstable angina pectoris, sudden death and nonsudden death. The costs for diagnostic and therapeutic service for patients with CAD were linked to medical decision algorithms outlining the diagnosis and management of patients with CAD. Because CAD is a changing illness not represented by a single event, the algorithm tracked patients for 5 years after the time of diagnosis, or until death, to develop average cost estimates. The estimated 5-year costs (in 1986 United States dollars) of the 5 CAD events were: acute myocardial infarction $51,211, angina pectoris $24,980, unstable angina pectoris $40,581, sudden death $9,078 and nonsudden death $19,697. The costs of major CAD surgical procedures were also calculated because of their impact on health care costs for patients with CAD. These include: coronary artery bypass surgery per case over 5 years $32,465, and angioplasty per case over 5 years $26,916. The high cost of CAD reflects the improved technology and more effective and expensive therapies now available.
基于弗明汉姆研究中确定的5种主要事件，已经开发出一种模型来确定冠状动脉疾病（CAD）的成本，这5种主要事件为：急性心肌梗死、心绞痛、不稳定型心绞痛、猝死和非猝死。CAD患者的诊断和治疗服务成本与概述CAD患者诊断和管理的医学决策算法相关联。由于CAD是一种并非由单一事件所代表的不断变化的疾病，该算法在诊断后对患者进行了5年的跟踪，直至患者死亡，以得出平均成本估算。这5种CAD事件的5年成本估算（以1986年美元计）分别为：急性心肌梗死51,211美元、心绞痛24,980美元、不稳定型心绞痛40,581美元、猝死9,078美元和非猝死19,697美元。由于主要CAD外科手术对CAD患者的医疗保健成本有影响，因此也计算了其成本。这些成本包括：每例冠状动脉搭桥手术5年的成本为32,465美元，每例血管成形术5年的成本为26,916美元。CAD的高成本反映了目前可用的技术改进以及更有效且更昂贵的治疗方法。
