Costs and medical care consequences associated with the diagnosis of peripheral arterial disease.
BACKGROUND
Peripheral arterial disease (PAD) is increasingly recognised as an indicator of disseminated atherothrombosis, but its impact on use of healthcare resources is not well understood.


OBJECTIVE
To provide a quantitative description of the resource utilisation and costs incurred following PAD.


METHODS
Hospitalisations, physician visits and the corresponding direct medical costs were examined in 16,440 patients with a diagnosis of PAD (1985--1995) in Saskatchewan, Canada, and compared with 15,590 reference patients with a diagnosis of myocardial infarction (MI) [1990--1995]. Medical history and patient characteristics were available retrospectively to January 1980 and follow-up to December 2000. Rates and timing of all-cause and cardiovascular hospitalisations and physician visits within discrete periods in the 10 years following PAD diagnosis, and 5 years following MI, were evaluated, as were lengths of stay and predictors of hospitalisation.


RESULTS
Average follow-up was 5.9 years among patients with PAD and 3.6 years for MI. Half (55%) of patients with PAD were male versus 64% of reference patients. The mean ages were 67.3 and 66.9 years, respectively. Patients with PAD were hospitalised most frequently soon after diagnosis, with rates subsequently decreasing to 0.14 per month. These rates were similar in the reference group except for the period immediately following MI. The average 5-year cost post-diagnosis (2002 Can dollars) per patient was 41,968 Can dollars vs 48,578 Can dollars for the reference population.


CONCLUSIONS
A diagnosis of PAD not only imposes a severe burden on patients and their families, but it also significantly increases the use of healthcare resources and the associated costs. By the end of year 1, this burden is comparable with a diagnosis of MI.
Caro Research Institute, Boston, Massachusetts 01742, USA.
Kristen
K
Migliaccio-Walle
J Jaime
JJ
Caro
Khajak J
KJ
Ishak
Judith A
JA
O'Brien
D000368:Aged; D002170:Canada; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D011320:Primary Health Care / Q000191:economics*; D012189:Retrospective Studies