Cost of illness for chronic stable angina patients enrolled in a self-management education trial.
BACKGROUND
Chronic stable angina (CSA) is a major debilitating health problem in Canada. A paucity of relevant cardiovascular data sets has precluded a detailed examination of the impact of interventions on CSA-related costs and its broader economic burden.


OBJECTIVE
As part of a larger clinical trial, the authors sought to determine the short-term impact of a standardized self-management training program on CSA-related costs. A secondary objective was to estimate the total annualized cost of CSA per patient from a societal perspective.


METHODS
Pre- and three-month post-test cost data were collected on 117 participants using the Ambulatory Home Care Record. Mean annualized direct, indirect and system-related CSA costs (2003 to 2005) were estimated; total per-patient CSA costs from a societal perspective were calculated as the sum of these costs.


RESULTS
The mean (+/- SD) age of participants was 68+/-11 years; 80% were male. The program did not impact costs in the short-term. Direct annual out-of-pocket costs, including money paid for health care, travel to appointments, medication, equipment and home support totaled $3,267. Indirect costs, reflecting the value of all unpaid time spent by those engaged in angina-related care, were $12,963. System costs, including costs paid by public and private insurers, were $2,979. Total estimated annual CSA costs from a societal perspective were $19,209 per patient.


CONCLUSIONS
These data suggest that CSA imposes a major economic burden, comparable with other prevalent conditions such as chronic noncancer pain. Advancements in self-management training research are needed to help reduce the economic burden of CSA in Canada.
Faculty of Nursing, University of Toronto, Toronto, Canada. michael.mcgillion@utoronto.ca
Michael H
MH
McGillion
Ruth
R
Croxford
Judy
J
Watt-Watson
Sandra
S
Lefort
Bonnie
B
Stevens
Peter
P
Coyte
D000368:Aged; D000787:Angina Pectoris / Q000191:economics* / Q000628:therapy; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009864:Ontario; D010353:Patient Education as Topic / Q000379:methods*; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods*; D014505:Urban Population