[Costs of coronary heart diseases over the remaining life time in coronary heart disease cases--an analysis of the current status of coronary heart disease cases in Germany from the social perspective].
Cardiovascular diseases are the major cause of death not only in Germany. Coronary heart diseases result in substantial disability and loss of productivity and contribute to escalating costs of health care.


OBJECTIVE
It was our objective to estimate the costs of CHD for the German population from the perspective of the society. The characteristic of this approach is the calculating of costs until the approximated end of life.


METHODS
In the study, all health care costs concerning CHD in Germany were allocated to age, sex, health care sector and primary diagnosis on the basis of comprehensive data on morbidity, mortality, direct and indirect costs. For the estimate of indirect costs the human capital approach was taken. Considered as cases were all patients hospitalized in the reference year (1996). The costs of this cohort in 1996 and up to their protected end of life were estimated. It was taken into account that, in comparison to the general population, life expectancy of cases with risk factors or CHD would have been reduced. In calculating indirect costs, gender and age specific unemployment rates were considered. All future costs were discounted by 4% from the reference year onward.


RESULTS
Direct costs are approximately 39 billion DM discounted at 4%, indirect costs total 73 billion DM. The average cost per case (including morbidity and mortality) until the approximated end of life is nearly 125,000 DM.


CONCLUSIONS
In our cost analysis, the indirect costs are higher than the direct costs. For the future, it will be important to estimate the costs of prevalent cases until the end of life and to compare the influence of different interventions on these parameters and on the whole budget of the social security system.
Klever-Deichert
G
G
Institut für Gesundheitsökonomie und klinische Epidemiologie, Universität zu Köln.
Hinzpeter
B
B
Hunsche
E
E
Lauterbach
K W
KW
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000191:economics* / Q000401:mortality; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D019057:Quality-Adjusted Life Years; D015996:Survival Rate