The Real Cost of Peripheral Artery Disease
The costs of chronic diseases represent a significant burden on the U.S. healthcare system. With the ageing population and the increasing prevalence of diabetes, cardiovascular diseases have become widely prevalent and account for the use of a rising percentage of scarce healthcare resources. While the costs of other cardiovascular diseases, such as myocardial infarction and stroke, have been extensively studied the healthcare and economic costs of peripheral artery disease have not.
With a 2010 prevalence of 17.6 million, peripheral artery disease is more common than coronary heart disease (16.3 million according to the American Heart Association). Approximately 18% of the population age 65 and older suffers from lower limb disease. Peripheral artery disease (PAD) is recognized as a marker for advanced systemic atherosclerosis and these patients suffer from a higher risk of cardiovascular events.
This report reviews, analyzes and assesses the current peer-reviewed literature published on the U.S. costs of PAD. In order to compare costs from studies reporting data in different years, all cost data is translated into 2010 dollars. Selected non-U.S. research is included in the discussion and analysis of cardiovascular morbidity and mortality.
Annual per patient costs for symptomatic as well as asymptomatic disease are analyzed in terms of dollar amount, cause and location (inpatient versus outpatient). Costs and reasons for the costs are assessed over time. Data is also provided on these variables for symptomatic PAD by disease severity. Patient populations include those in the U.S. reduction of atherothrombosis for continued health (REACH) registry, managed care patients as well as those covered by Medicare.
The Saskatchewan study provides valuable, long-term data on the costs and medical consequences of PAD. This study includes a comparison of annual hospitalization rates for PAD and myocardial infarction patients by cause.
The presence of polyvascular disease and its impact on costs, mortality and morbidity in PAD patients is discussed and analyzed.
THE SAGE GROUP’S comprehensive analysis of inpatient cost and outcomes data is also included. This analysis compares PAD discharges with all discharges according to age, per patient charges and by payer with special emphasis on the Medicare and Medicaid populations. Outcomes (length of stay, mortality and discharge status) for PAD are assessed by disease severity.
The national inpatient bills for peripheral artery disease, coronary heart disease and cerebrovascular disease are assessed and compared. The national bills, average charges and discharges for the most severe forms of these three cardiovascular diseases (heart attack, stroke and critical limb ischemia) are also compared.
Based on the premise that a portion of the costs of diabetic foot ulcers can be attributed to PAD, the report includes a discussion and analysis of the prevalence of ischemic ulcers as well as the per patient and total costs of diabetic foot ulcers, which are attributable to the presence of peripheral artery disease.
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