title: The direct medical cost of cardiovascular diseases, hypertension, diabetes, cancer, pregnancy and female infertility in a large HMO in Israel.
abstract: OBJECTIVE
  The aim of this study was to assess the direct medical cost of treating major chronic illnesses in Maccabi Healthcare Services, a 1.8 million member health maintenance organization in Israel.
  
  
  METHODS
  Direct medical costs were calculated for each member in 2006. We used multiple linear regression models to evaluate the overall costs of chronic conditions (cardiovascular diseases, diabetes mellitus, hypertension, female infertility treatments, and cancer), pregnancy and treatments for female infertility.
  
  
  RESULTS
  According to the study model, hypertension was associated with the largest direct medical costs in both sexes. Cardiovascular diseases accounted for 9.5% of the total direct medical costs in men, but only 5.9% in women. Diabetes mellitus accounted for 3.5% of the total medical costs both in men and women and is comparable to the total pregnancy-related costs in women.
  
  
  CONCLUSIONS
  The findings indicate that hypertension, diabetes mellitus and female infertility treatments impose a considerable economic burden on public healthcare services in Israel which is comparable with the costs of cancer and cardiovascular diseases.
authors.affiliation: Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. hodik_g@mac.org.il
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.forename: Avi
authors.initials: A
authors.lastname: Porath
authors.forename: Hillel
authors.initials: H
authors.lastname: Alapi
authors.forename: Tal
authors.initials: T
authors.lastname: Sella
authors.forename: Shira
authors.initials: S
authors.lastname: Flash
authors.forename: Francis
authors.initials: F
authors.lastname: Wood
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000191:economics / Q000453:epidemiology; D007247:Infertility, Female / Q000191:economics* / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008427:Maternal Health Services / Q000191:economics; D008875:Middle Aged; D015999:Multivariate Analysis; D009313:National Health Programs / Q000191:economics; D009369:Neoplasms / Q000191:economics / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence