News Roundup [abridged Versions Appear In The Paper Journal]

Heart disease is costliest condition to treat

BMJ 2003; 326 doi: (Published 29 March 2003) Cite this as: BMJ 2003;326:679
  1. Roger Dobson
  1. Abergavenny

    Heart disease has come top of a league table of costs of treatment for the 15 most expensive conditions in the United States.

    A new study that analysed annual healthcare costs in the United States has found that heart disease, cancer, and trauma are the three biggest conditions in terms of cost. The combined costs of these three groups alone were almost $150bn (£95bn; ‡140bn) in 1997, the year for which data were analysed.

    The analysis, which was carried out by researchers at the Agency for Healthcare Research and Quality, also shows that more than 17 million people in the United States had a diagnosis of heart disease diagnosis in 1997. Nine million people had cancer, 37 million had trauma, and 20 million had mental disorders.

    A report of the analysis says while many of the top 15 conditions were chronic diseases, several were acute conditions, “which one might not have expected to account for such high spending levels.” The report adds, “This suggests that while a focus on chronic conditions is certainly important, it should not be the only focus of efforts at improvement.”

    The analysis shows that private insurance covered at least 35% of the costs for the top five conditions, including more than half of the costs associated with cancer. Medicare covered nearly 45% of costs of heart disease, between 20% and 25% of costs associated with cancer and trauma, 16% for mental disorders, and 30% for pulmonary conditions.

    The proportion of expenses paid by patients themselves was highest for hypertension, at 30%, and lowest for pneumonia, at 4.1%.

    The 15 costliest treatments (and number of people with diagnosis) in 1997

    • Heart disease $58bn (17 million)

    • Cancer $46bn (9 million)

    • Trauma $44bn (37 million)

    • Mental disorders $30bn (20 million)

    • Diabetes $20bn (10 million)

    • Hypertension $18bn (27 million)

    • Cerebrovascular disease $16bn (2 million)

    • Osteoarthritis $16bn, (16 million)

    • Pneumonia $16bn (4 million)

    • Back problems $13bn (13 million)

    • Kidney disease $10bn (2 million)

    • Endocrine disorders $10bn (18 million)

    • Skin disorders $9bn (20 million)

    • Infectious diseases $6bn (16 million)

    Spending and service use among people with the fifteen most costly medical conditions, 1997 is available at:

    View Abstract

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