title: The direct and indirect cost burden of acute coronary syndrome.
abstract: OBJECTIVE
  Quantify the incremental health care costs and workplace absence and short-term disability costs, to payers and employers, of patients hospitalized for acute coronary syndrome (ACS).
  
  
  METHODS
  Retrospective study using medical insurance claims for the years 2002 to 2007. Patients were aged 18 to 64 years and hospitalized for ACS between January 1, 2003, and December 31, 2006; comparison patients without evidence of coronary artery disease were also selected. The incremental impact of ACS was estimated using weighted regression.
  
  
  RESULTS
  30,200 ACS patients were selected. Incremental annual direct costs of ACS were $40,671 (P < 0.001). For the indirect cost sub-analyses, incremental short-term disability costs of ACS were $999 (P < 0.001) and incremental absence costs were insignificant (P = 0.314) but from a small sample (N = 416).
  
  
  CONCLUSIONS
  Patients with ACS impose a substantial direct cost burden on employers and payers and a substantial indirect cost burden on employers. Acute coronary syndrome is more costly to employers and payers than other health conditions that are common among employed persons. Rehospitalizations after the initial hospitalization are common and represent a large portion of the cost.
authors.affiliation: Thomson Reuters, Washington, DC, USA. stephen.johnston@thomsonreuters.com
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Johnston
authors.forename: Suellen
authors.initials: S
authors.lastname: Curkendall
authors.forename: Dinara
authors.initials: D
authors.lastname: Makenbaeva
authors.forename: Essy
authors.initials: E
authors.lastname: Mozaffari
authors.forename: Ron
authors.initials: R
authors.lastname: Goetzel
authors.forename: Wayne
authors.initials: W
authors.lastname: Burton
authors.forename: Ross
authors.initials: R
authors.lastname: Maclean
mesh_terms: D054058:Acute Coronary Syndrome / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies