Economic burden of cardiovascular diseases in Serbia

Abstract

Background/Aim. Cardiovascular disease imposes a burden to society in terms of mortality, morbidity and economic losses. The aim of this study was to estimate the economic burden of cardiovascular disease in Serbia in 2009 from the perspective of the society. Methods. For the purpose of the study cardiovascular disease was defined by the International Classification of Diseases, 10th revision, as the following diagnosis: hypertension, coronary heart disease, cardiomyopathy, heart failure and cerebrovascular disease. The prevalence, top-down method was used to quantify the annual cardiovascular costs. Productivity losses were estimated using the human capital approach and the friction cost method. A discount rate of 5% was used to convert all future lifetime earnings into the present value. Results. The total direct costs of cardiovascular disease in 2009 were € 400 million. The results showed that more than half a million working days were lost due to incapacity resulting from cardiovascular diseases, yielding the € 113.9 million. The majority of total costs (€ 514.3 million) were for: medication (29.94%), hospital days (28.97%) and hospital inpatient care - surgical and diagnostic interventions (17.84%). The results were robust to a change in 20% of volume or the unit price of all direct and indirect cost and to discount rate 2% and 10%. Conclusions. The total cardiovascular disease costs in 2009 represented approximately 1.8% of the Serbian gross domestic product. The results of the study would be valuable to health policy makers to bridge the gap between invested resources and needs, in order to improve cardiovascular disease outcomes.

Uvod/Cilj. Kardiovaskularne bolesti predstavljaju teret za društvo u smislu mortaliteta, morbiditeta i ekonomskih gubitaka. Cilj ove studije bio je procena ekonomskog značaja kardiovaskularnih bolesti u Srbiji u 2009. godini iz perspektive društva. Metode. Za potrebe istraživanja, kardiovaskularne bolesti su definisane pomoću Međunarodne klasifikacije bolesti, 10. revizija, kao sledeće dijagnoze: hipertenzija, koronarne bolesti, kardiomiopatija, srčana insuficijencija i cerebrovaskularne bolesti. Korišćen je top-down metod, baziran na prevalenciji, kako bi se kvantifikovali godišnji kardiovaskularni troškovi. Troškovi smanjene produktivnosti su procenjeni korišćenjem dva pristupa: pristup ljudskom kapitalu (human capital approach) i metod frikcionih troškova (friction cost method). Za obračunavanje troškova u sadašnju vrednost korišćena je diskontna stopa od 5%. Rezultati. Ukupni direktni troškovi kardiovaskularnih bolesti u 2009. godini iznosili su 400 miliona evra. Rezultati pokazuju da je više od pola miliona radnih dana izgubljeno zbog nesposobnosti usled kardiovaskularnih bolesti, dajući ukupno 113,9 miliona evra indirektne troškove. Većina ukupnih troškova (514,3 miliona evra) bili su za: lekove (29,94%), hospitalizaciju (28,97%) i bolničko lečenje - hirurške intervencije i dijagnostiku (17,84%). Rezultati su bili robusni na promene od 20% u volumenu ili ceni pojedinih kategorija troškova, kao i na primenjenu diskontnu stopu od 2% i od 10%. Zaključak. Ukupni troškovi kardiovaskularnih bolesti u 2009. godini su predstavljali oko 1,8% bruto domaćeg proizvoda. Rezultati studije su značajni za kreiranje zdravstvene politike i premošćavanja jaza između uloženih sredstava i potreba, a u cilju poboljšanja ishoda kardiovaskularnih bolesti.