Sagmeister M, Gessner U, Oggier W, Horisberger B, Gutzwilller F
Department of Internal Medicine, University Hospital Zurich, Switzerland.
Eur Heart J. 1997 Jul;18(7):1102-9. doi: 10.1093/oxfordjournals.eurheartj.a015404.
Direct and indirect costs of ischaemic heart disease were assessed in Switzerland, for the period 1988-1993, in order to evaluate the economic consequences of more intensive treatment of the disease and of the decreasing mortality from ischaemic heart disease in the working population.
A societal perspective was taken for a prevalence-based assessment of the direct (total resources consumed by outpatients and inpatients) and indirect (due to morbidity, invalidity, and premature death, using the human capital approach) costs. The results showed the total costs were 21 million US dollars per 100000 population in the year 1993 (47% direct, 53% indirect costs). The largest components were the direct costs of inpatient care and indirect costs due to premature death (each approximately 25% of the total). Trends showed a large increase in direct costs (+9% per year, constant dollars). Indirect costs stabilized or decreased slightly due to the reduction of work losses.
Today's medicine and preventive measures have proven effective for ischaemic heart disease, although such remedies have required increasingly large financial resources. However, society benefits because indirect costs decrease, although this gain does not compensate for all direct costs.
评估1988 - 1993年期间瑞士缺血性心脏病的直接和间接成本，以评估对该疾病进行更强化治疗以及在职人群中缺血性心脏病死亡率下降所带来的经济后果。
从社会角度出发，基于患病率对直接成本（门诊和住院患者消耗的总资源）和间接成本（采用人力资本法，因发病、残疾和过早死亡导致的成本）进行评估。结果显示，1993年每10万人口的总成本为2100万美元（直接成本占47%，间接成本占53%）。最大的组成部分是住院护理的直接成本和过早死亡导致的间接成本（各约占总成本的25%）。趋势表明直接成本大幅增加（每年增长9%，按不变美元计算）。由于工作损失的减少，间接成本趋于稳定或略有下降。
当今的医学和预防措施已被证明对缺血性心脏病有效，尽管这些疗法需要越来越多的财政资源。然而，社会从中受益，因为间接成本下降，尽管这一收益无法弥补所有直接成本。
