Treatment costs and quality of life of patients with peripheral arterial occlusive disease--the German perspective.
BACKGROUND
To objectify the debate about the restricted resources of the health system, examinations about the treatment costs and quality of life implications of different illnesses are necessary. The aims of the examination were the quantification of costs that are caused by a patient with PAD per year and the determination of the quality of life.


METHODS
280 patients (mean 66.6 years) in Fontaine stages II to IV were included in the study to determine their treatment costs for the year 2001 retrospectively from patient records. Health-related quality of life was recorded through the standardized questionnaires PAVK-86, SF-36 and EQ-5D.


RESULTS
A patient with PAD in stage Ila costs on average 1792.45 Euros, in stage IIb 2551.28 Euros, in stage III 4356.48 Euros and in stage IV 6225.89 Euros. The costs of the in-hospital treatment dominated the total result on average with 44.4% of the direct costs. Further cost factors were the drugs with 33.4%, the out-patient medical treatment with 9.9%, the expenditures for care with 6.7%, rehabilitation with 3.6% and adjuvants with a share of 1.9%. The indirect costs played a subordinate role with 9.67% of the total costs. The quality of life was clearly restricted in all stages of the PAD. The quality of life especially was strongly decreased from the Fontaine stage IIb on. The problems were mainly in the areas of the physicalfunctions and pain.


CONCLUSIONS
The study showed that the treatment of patients with PAD is very cost-intensive and that patients have to suffer from a considerable loss of quality of life.
Holler
D
D
Schwarz Pharma Deutschland GmbH, Monheim, Germany. dirk.holler@schwarzpharma.com
Claes
C
C
von der Schulenburg
J M
JM
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome