title: Burden of illness among patients at high risk versus low risk for major cardiovascular events.
abstract: OBJECTIVE
  This study was designed to compare the burden of illness (BOI) in patients at high risk versus low risk of developing a major cardiovascular (CV) event.
  
  
  METHODS
  This retrospective claims data analysis included commercial health plan members identified with a primary diagnosis on a medical claim for cardiovascular disease (CVD) from January 1, 2001 through December 31, 2002. Patients were categorized as: low risk (LR), high risk (HR), or high risk aged≥55 (HR55), based on the ONTARGET clinical trial.
  
  
  RESULTS
  Most patients (85%) were in the LR category (8% in HR55, 7% in HR). A significantly greater proportion of patients in the HR55 group were hospitalized and experienced a greater number of ambulatory visits compared with LR and HR patients. Controlling for covariates, HR55 patients averaged $22,502 in paid healthcare services over 2 years versus $15,645 for HR patients and $11,423 for LR patients (p<0.001). CV-related costs represented about 46% of costs for the HR55 group, versus 41% for the HR group and 31% for the LR group.
  
  
  CONCLUSIONS
  Claims data are collected for the purpose of payment and not research and the presence of a diagnosis code is not proof of disease, due to possible coding errors or the use of a rule-out criterion. Also, patients who died in the follow-up were not included in the analyses, resulting in lower BOI estimates. Finally, the results of this study reflect treatment of CVD in managed-care settings, and may not be applicable to a different type of population.
  
  
  CONCLUSIONS
  This study demonstrates the high BOI associated with CVD, especially for patients within the high-risk group aged≥55 years. Opportunities exist for reducing costs in this population.
authors.affiliation: i3 Innovus, Eden Prairie, MN, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Harley
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Sander
authors.forename: Victoria
authors.initials: V
authors.lastname: Zarotsky
authors.forename: Feng
authors.initials: F
authors.lastname: Cao
authors.forename: Hemal
authors.initials: H
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000191:economics* / Q000628:therapy; D017281:Cost of Illness; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D055815:Young Adult