title: Prevalence and economic burden of cardiovascular diseases in France in 2013 according to the national health insurance scheme database.
abstract: BACKGROUND
  Cardiovascular diseases (CVDs) constitute the second leading cause of death in France. The Système national d'information interrégimes de l'assurance maladie (SNIIRAM; national health insurance information system) can be used to estimate the national medical and economic burden of CVDs.
  
  
  OBJECTIVE
  To describe the rates, characteristics and expenditure of people reimbursed for CVDs in 2013.
  
  
  METHODS
  Among 57 million general health scheme beneficiaries (86% of the French population), people managed for CVDs were identified using algorithms based on hospital diagnoses either during the current year (acute phase) or over the previous 5 years (chronic phase) and long-term diseases. The reimbursed costs attributable to CVDs were estimated.
  
  
  RESULTS
  A total of 3.5 million people (mean age, 71 years; 42% women) were reimbursed by the general health scheme for CVDs (standardized rate, 6.5%; coronary heart disease, 2.7%; arrhythmias/conduction disorders, 2.1%; stroke, 1.1%; heart failure, 1.1%). These frequencies increased with age and social deprivation, and were higher in Northern and Eastern France and Réunion Island. The total sum reimbursed by all schemes for CVDs was € 15.1 billion (50% for hospital care and 43% for outpatient care [including 15% for drugs and 12% for nurses/physiotherapists]); coronary heart disease accounted for € 4 billion, stroke for € 3.5 billion and heart failure for € 2.5 billion (i.e. 10% of the total expenditure reimbursed by all national health insurance schemes for all conditions).
  
  
  CONCLUSIONS
  CVDs constitute the leading group in terms of numbers of patients reimbursed and total reimbursed expenditure, despite a probable underestimation of both numbers and expenditure.
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France. Electronic address: philippe.tuppin@cnamts.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Tuppin
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Rivière
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Rigault
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Tala
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Drouin
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Pestel
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Denis
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Gastaldi-Ménager
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Gissot
authors.affiliation: Cardiologie, Institut lorrain du cœur et des vaisseaux Louis-Mathieu, Nancy, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Fagot-Campagna
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000465:Algorithms; D000553:Ambulatory Care / Q000639:trends; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D057225:Data Mining; D016208:Databases, Factual; D016527:Drug Costs / Q000639:trends; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000639:trends*; D005102:Health Expenditures / Q000639:trends*; D017721:Hospital Costs / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007349:Insurance, Health, Reimbursement / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D015995:Prevalence; D013997:Time Factors; D055815:Young Adult
keywords: Cardiovascular diseases; Comorbidities; Comorbidités; Costs; Coûts; Maladies cardiovasculaires; Prevalence; Prévalence; SNIIRAM; Sniiram