Pestana J A, Steyn K, Leiman A, Hartzenberg G M
School of Economics, University of Cape Town.
S Afr Med J. 1996 Jun;86(6):679-84.
In South Africa, cardiovascular disease (CVD) is the leading cause of death among all population groups, other than blacks, among whom it ranks third. CVD therefore has a severe impact on the South African economy.
To ascertain the availability and quality of South African data on the cost of CVD and to estimate the impact of CVD on the South African economy during 1991.
The direct health care costs and the indirect costs related to loss of productivity were estimated. Where no direct or complete detailed South African data were available, projections were made based on reasonable assumptions of data and models developed in other countries; these were applied to the limited available South African data. The major disease outcomes considered for this cost estimation were: expenditure on ischaemic heart disease, cerebrovascular disease (stroke), venous thrombosis and embolism, and peripheral vascular diseases and related conditions. These diseases are responsible for the majority of fatal cases of CVD reported in South Africa.
The estimated total cost of CVD in South Africa in 1991 was between R4.135 billion and R5.035 billion. This does not include the cost of rehabilitation and follow-up of CVD patients since the necessary data were not available to estimate it. About three-quarters of the direct health care costs were carried by the private sector. The direct health care costs were estimated to be approximately 42% of the total cost. The rest reflects the indirect cost of earnings foregone as a result of premature morbidity and mortality.
To determine accurately the total economic burden of CVD on the South African economy, additional data will have to be collected. The estimated economic burden of CVD in South Africa clearly highlights the need for a broad-based population strategy, part of an overall national effort to prevent, diagnose and cost-effectively treat CVD.
在南非，心血管疾病（CVD）是所有人群（黑人除外，在黑人中CVD位列第三）的主要死因。因此，心血管疾病对南非经济造成了严重影响。
确定南非有关心血管疾病成本的数据的可得性和质量，并估算1991年心血管疾病对南非经济的影响。
估算了直接医疗成本以及与生产力损失相关的间接成本。在没有直接或完整详细的南非数据时，根据其他国家的数据和模型的合理假设进行预测；这些预测应用于有限的可得南非数据。此次成本估算考虑的主要疾病结果包括：缺血性心脏病、脑血管疾病（中风）、静脉血栓形成和栓塞以及外周血管疾病及相关病症的支出。这些疾病占南非报告的心血管疾病死亡病例的大部分。
1991年南非心血管疾病的估计总成本在41.35亿兰特至50.35亿兰特之间。这并不包括心血管疾病患者的康复和随访成本，因为没有可用数据来估算这部分成本。约四分之三的直接医疗成本由私营部门承担。直接医疗成本估计约占总成本的42%。其余部分反映了因过早发病和死亡而放弃的收入的间接成本。
为了准确确定心血管疾病对南非经济的总体经济负担，必须收集更多数据。南非心血管疾病的估计经济负担清楚地凸显了需要一项基础广泛的人群战略，这是国家预防、诊断和经济高效治疗心血管疾病的总体努力的一部分。
