The Swedish Institute for Health Economics (IHE), Lund, Sweden.
Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
BMC Cardiovasc Disord. 2023 Sep 29;23(1):483. doi: 10.1186/s12872-023-03518-y.
To examine direct and indirect costs, early retirement, cardiovascular events and mortality over 5 years in people with atherosclerotic cardiovascular disease (ASCVD) and matched controls in Sweden.
Individuals aged ≥ 16 years living in Sweden on 01 January 2012 were identified in an existing database. Individuals with ASCVD were propensity score matched to controls without ASCVD by age, sex and educational status. We compared direct healthcare costs (inpatient, outpatient and drug costs), indirect costs (resulting from work absence) and the risk of stroke, myocardial infarction (MI) and early retirement.
After matching, there were 231,417 individuals in each cohort. Total mean per-person annual costs were over 2.5 times higher in the ASCVD group versus the controls (€6923 vs €2699). Indirect costs contributed to 60% and 67% of annual costs in the ASCVD and control groups, respectively. Inpatient costs accounted for ≥ 70% of direct healthcare costs. Cumulative total costs over the 5-year period were €32,011 in the ASCVD group and €12,931 in the controls. People with ASCVD were 3 times more likely to enter early retirement than controls (hazard ratio [HR] 3.02 [95% CI 2.76-3.31]) and approximately 2 times more likely to experience stroke (HR 1.83 [1.77-1.89]) or MI (HR 2.27 [2.20-2.34]).
ASCVD is associated with both economic and clinical impacts. People with ASCVD incurred considerably higher costs than matched controls, with indirect costs resulting from work absence and inpatient admissions being major cost drivers, and were also more likely to experience additional ASCVD events.
在瑞典，调查动脉粥样硬化性心血管疾病（ASCVD）患者与匹配对照者在 5 年内的直接和间接成本、提前退休、心血管事件和死亡率。
在一个现有数据库中确定 2012 年 1 月 1 日居住在瑞典的年龄≥16 岁的个体。根据年龄、性别和教育程度，对 ASCVD 患者进行倾向评分匹配，以匹配无 ASCVD 的对照者。我们比较了直接医疗保健成本（住院、门诊和药物成本）、间接成本（因工作缺勤造成的成本）以及中风、心肌梗死（MI）和提前退休的风险。
匹配后，两组各有 231417 人。ASCVD 组的人均年总费用比对照组高出 2.5 倍以上（€6923 比€2699）。ASCVD 组和对照组的间接成本分别占年度成本的 60%和 67%。住院费用占直接医疗保健费用的≥70%。在 5 年期间，ASCVD 组的累计总成本为€32011，对照组为€12931。ASCVD 患者提前退休的可能性是对照组的 3 倍（风险比 [HR] 3.02 [95% CI 2.76-3.31]），发生中风（HR 1.83 [1.77-1.89]）或 MI（HR 2.27 [2.20-2.34]）的可能性约为对照组的 2 倍。
ASCVD 既与经济影响有关，也与临床影响有关。ASCVD 患者的费用明显高于匹配对照者，缺勤和住院是主要的成本驱动因素，间接成本也较高，并且发生 ASCVD 事件的可能性也更高。
