Rittiphairoj Thanitsara, Bulstra Caroline, Ruampatana Chochat, Stavridou Maria, Grewal Sagar, Reddy Che L, Atun Rifat
Health Systems Innovation Lab, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
Division of Health Systems Management, Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
BMJ Glob Health. 2025 Feb 12;10(2):e015043. doi: 10.1136/bmjgh-2024-015043.
There is a dearth of evidence regarding the global economic burden of ischaemic heart diseases (IHDs). This systematic review aims to synthesise national-level studies worldwide quantifying the economic burden of IHDs from a provider's perspective.
We searched PubMed, Embase, Cochrane, DARE and EconLit databases from 1 January 2000 to 29 June 2022. We included observational, cost-of-illness and economic modelling studies reporting direct healthcare cost data for IHDs at the national level. At least two reviewers independently screened titles and abstracts and full texts, extracted data and assessed quality using a seven-question assessment tool. We synthesised findings by country, focusing on three key economic estimates: total annual costs of IHDs, costs of managing acute IHD episodes and chronic IHD care. We correlated these costs with country-specific macroeconomic measures and disease burden.
We included 65 national-level studies conducted in 21 countries worldwide, with a majority in high-income countries. The median direct healthcare cost per episode of IHDs was 8062 Int$ 2019 (IQR: 5770-9580), and the median direct healthcare cost of IHDs per patient-year was 10 064 Int$ 2019 (IQR: 7619-14 818). These estimates positively correlated with country-specific macroeconomic and DALY measures.
IHDs impose a substantial economic burden on health systems globally. Economic costs in countries exceed per capita public health expenditure, primarily driven by acute episodes. National-level data were available for only 21 countries, and none from low-middle-income and low-income countries. Economic costs of IHDs need to be quantified to inform resource allocation decisions at national and global levels.CRD42022337577.
关于缺血性心脏病（IHD）的全球经济负担，证据不足。本系统评价旨在综合全球范围内从提供者角度量化IHD经济负担的国家级研究。
我们检索了2000年1月1日至2022年6月29日期间的PubMed、Embase、Cochrane、DARE和EconLit数据库。我们纳入了在国家级报告IHD直接医疗成本数据的观察性、疾病成本和经济建模研究。至少两名评审员独立筛选标题、摘要和全文，提取数据并使用一个七问题评估工具评估质量。我们按国家汇总研究结果，重点关注三个关键经济估计值：IHD的年度总成本、急性IHD发作管理成本和慢性IHD护理成本。我们将这些成本与特定国家的宏观经济指标和疾病负担相关联。
我们纳入了在全球21个国家进行的65项国家级研究，其中大多数来自高收入国家。IHD每次发作的直接医疗成本中位数为8062国际元2019（四分位间距：5770 - 9580），IHD每位患者每年的直接医疗成本中位数为10064国际元2019（四分位间距：7619 - 14818）。这些估计值与特定国家的宏观经济和伤残调整生命年指标呈正相关。
IHD给全球卫生系统带来了巨大的经济负担。各国的经济成本超过人均公共卫生支出，主要由急性发作驱动。仅21个国家有国家级数据，没有来自中低收入和低收入国家的数据。需要量化IHD的经济成本，以为国家和全球层面的资源分配决策提供依据。CRD42022337577
