Estimating medical costs of work-related diseases in the Basque Country (2008).
OBJECTIVE
To estimate the medical costs of work-attributable diseases (WAD) treated by the public health care system for one of the Spanish Autonomous Communities, the Basque Country, in 2008.


METHODS
We calculated the burden of disease attributable to work for each category of diseases according to ICD-9-CM by using estimates of attributable fractions. Hospital and specialized outpatient care cost data were derived from the Spanish National Health System analytical accountability system. Secondary sources of information were used to estimate primary health care and drug prescriptions.


RESULTS
Direct costs of work-attributable diseases borne by the Basque Regional Health Service totalled 106 million Euros in 2008, representing 3.3% of Basque public expenditures on health and 0.16% of Basque GDP in 2008. Specialized care, including hospitalizations, absorbed the highest proportion of costs (52%), followed by drug prescriptions and primary health care (27% and 21%, respectively). Diseases of the musculoskeletal system and connective tissues accounted for 47.3% of total costs, followed by cardiovascular diseases (19.6%) and cancer (15%).


CONCLUSIONS
Occupational diseases and accidents are costly in the Basque Region of Spain, generating a severe deviation of public expenditures and overburdening of the Public Health System because they should really be the responsibility of the Social Security System. Proper identification and assignment of costs of work-related diseases would result in significant savings for the National Health System (Spanish and European), would provide an incentive for the prevention of these avoidable causes of illness and thus contribute to the sustainability of social systems.
Ministry of Health, Social Services and Equality. Madrid, Spain. mgarciag@msssi.es
Montserrat García
MG
Gómez
R
R
Castañeda
Patricia López
PL
Menduiña
Rosa Urbanos
RU
Garrido
S
S
Markowitz
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D003953:Diagnosis-Related Groups; D016527:Drug Costs / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics; D006801:Humans; D038801:International Classification of Diseases; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D009784:Occupational Diseases / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D011306:Prescription Fees / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000191:economics; D012943:Social Security / Q000191:economics; D013030:Spain / Q000453:epidemiology