Dataset Information

10-Year Resource Utilization and Costs for Cardiovascular Care.

ABSTRACT: BACKGROUND:Cardiovascular disease (CVD) imparts a heavy economic burden on the U.S. health care system. Evidence regarding the long-term costs after comprehensive CVD screening is limited. OBJECTIVES:This study calculated 10-year health care costs for 6,814 asymptomatic participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a registry sponsored by the National Heart, Lung, and Blood Institute, National Institutes of Health. METHODS:Cumulative 10-year costs for CVD medications, office visits, diagnostic procedures, coronary revascularization, and hospitalizations were calculated from detailed follow-up data. Costs were derived by using Medicare nationwide and zip code-specific costs, inflation corrected, discounted at 3% per year, and presented in 2014 U.S. dollars. RESULTS:Risk factor prevalence increased dramatically and, by 10 years, diabetes, hypertension, and dyslipidemia was reported in 19%, 57%, and 53%, respectively. Self-reported symptoms (i.e., chest pain or shortness of breath) were common (approximately 40% of enrollees). At 10 years, approximately one-third of enrollees reported having an echocardiogram or exercise test, whereas 7% underwent invasive coronary angiography. These utilization patterns resulted in 10-year health care costs of $23,142. The largest proportion of costs was associated with CVD medication use (78%). Approximately $2 of every $10 were spent for outpatient visits and diagnostic testing among the elderly, obese, those with a high-sensitivity C-reactive protein level >3 mg/l, or coronary artery calcium score (CACS) ?400. Costs varied widely from <$7,700 for low-risk (Framingham risk score <6%, 0 CACS, and normal glucose measurements at baseline) to >$35,800 for high-risk (persons with diabetes, Framingham risk score ?20%, or CACS ?400) subgroups. Among high-risk enrollees, CVD costs accounted for $74 million of the $155 million consumed by MESA participants. CONCLUSIONS:Longitudinal patterns of health care resource use after screening revealed new evidence on the economic burden of treatment and testing patterns not previously reported. Maintenance of a healthy population has the potential to markedly reduce the economic burden of CVD among asymptomatic individuals.

SUBMITTER: Shaw LJ

PROVIDER: S-EPMC5846485 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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10-Year Resource Utilization and Costs for Cardiovascular Care.

Shaw Leslee J LJ Goyal Abhinav A Mehta Christina C Xie Joe J Phillips Lawrence L Kelkar Anita A Knapper Joseph J Berman Daniel S DS Nasir Khurram K Veledar Emir E Blaha Michael J MJ Blumenthal Roger R Min James K JK Fazel Reza R Wilson Peter W F PWF Budoff Matthew J MJ

Journal of the American College of Cardiology 20180301 10

<h4>Background</h4>Cardiovascular disease (CVD) imparts a heavy economic burden on the U.S. health care system. Evidence regarding the long-term costs after comprehensive CVD screening is limited.<h4>Objectives</h4>This study calculated 10-year health care costs for 6,814 asymptomatic participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a registry sponsored by the National Heart, Lung, and Blood Institute, National Institutes of Health.<h4>Methods</h4>Cumulative 10-year costs f ...[more]

PMID: 29519347

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Dataset Information

10-Year Resource Utilization and Costs for Cardiovascular Care.

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10-Year Resource Utilization and Costs for Cardiovascular Care.

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