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Recent trends in economic burden of acute myocardial infarction in South Korea.

ABSTRACT: In 2010, ischemic heart disease was the leading cause of disability-adjusted life-years (DALYs) worldwide. More specially, the prevalence of acute myocardial infarctions (AMI) is increasing in the aged population as mortality decreases; South Korea is no exception. This study aims to examine the economic burden of AMI in the Korean population between 2007 and 2012. AMI-related costs were assessed from a societal perspective. A prevalence-based cost-of-illness framework was used for this analysis. The subjects included all South Koreans with AMI-related ICD-10 codes (I21, I22, I23, I25.0, and I25.1). Data on direct (medical and non-medical) costs and indirect (productivity loss due to AMI-associated morbidity and mortality) costs were collected from the Korean National Health Insurance Service's claims data. The human capital approach was used to calculate indirect costs. The total estimated cost of AMI in 2012 was $1,177,649,323 USD. The majority (52%) of this amount was made up of medical costs, followed by productivity losses due to mortality and morbidity (42% of annual cost). Although the total cost declined by approximately 18% compared to 2007 ($1,427,643,854 USD), the cost of AMI in the over 60 age group amounted to 47% of the total cost of AMI in 2012. AMI led to a high economic burden in 2012. This study, which identified not only the size, but also the trends of AMI-related costs, will provide information to evaluate effects of governmental health projects and the effective allocation of public research funds.

SUBMITTER: Seo H

PROVIDER: S-EPMC4319857 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:Background Trends in acute myocardial infarction (AMI) incidence rates for diverse races/ethnicities are largely unknown, presenting barriers to understanding the role of race/ethnicity in AMI occurrence. Methods and Results We identified AMI hospitalizations for Kaiser Permanente Southern California members, aged ≥35 years, during 2000 to 2014 using discharge diagnostic codes. We excluded hospitalizations with missing race/ethnicity information. We calculated annual incidence rates (age and sex standardized to the 2010 US census population) for AMI, ST-segment-elevation myocardial infarction, and non-ST-segment-elevation myocardial infarction by race/ethnicity (Hispanic and non-Hispanic racial groups: Asian or Pacific Islander, black, and white). Using Poisson regression, we estimated annual percentage change in AMI, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction incidence by race/ethnicity and AMI incidence rate ratios between race/ethnicity pairs, adjusting for age and sex. We included 18 630 776 person-years of observation and identified 44 142 AMI hospitalizations. During 2000 to 2014, declines in AMI, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction were 48.7%, 34.2%, and 69.8%, respectively. Age- and sex-standardized AMI hospitalization rates/100 000 person-years declined for Hispanics (from 307 to 162), Asians or Pacific Islanders (from 271 to 158), blacks (from 347 to 199), and whites (from 376 to 189). Annual percentage changes ranged from -2.99% to -4.75%, except for blacks, whose annual percentage change was -5.32% during 2000 to 2009 and -1.03% during 2010 to 2014. Conclusions During 2000 to 2014, AMI, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction hospitalization incidence rates declined substantially for each race/ethnic group. Despite narrowing rates among races/ethnicities, differences persist. Understanding these differences can help identify unmet needs in AMI prevention and management to guide targeted interventions.

Project description:We evaluated the survival rates and medical expenditure in patients with lung cancer using a nationwide claims database in South Korea. A retrospective observational cohort study design was used, and 2,919 lung cancer patients and their matched controls were included. Medical expenditures were analyzed with the Kaplan-Meier sample average method, and patients were categorized into 4 groups by operation and primary treatment method (i.e. Patients with operation: OP = surgery, OP+CTx/RTx = surgery with anti-cancer drugs or radiotherapy; Patients without operation: CTx/RTx = anti-cancer drugs or radiotherapy, Supportive treatment). The 5-year medical expenditure per case was highest in the OP+CTx/RTx group ($36,013), followed by the CTx/RTx ($23,134), OP ($22,686), and supportive treatment group ($3,700). Lung cancer-related anti-cancer drug therapy was the major cost driver, with an average 53% share across all patients. Generalized linear regression revealed that monthly medical expenditure in lung cancer patients, after adjustment for follow-up month, was approximately 3.1-4.3 times higher than that in the control group (cost ratio for OP = 3.116, OP+CTx/RTx = 3.566, CTx/RTx = 4.340, supportive treatment = 4.157). The monthly medical expenditure at end of life was estimated at $2,139 for all decedents, and approximately a quarter of patients had received chemotherapy in the last 3 months. In conclusion, this study presented the quantified treatment costs of lung cancer on various aspects compared with matched controls according to the treatment of choice. In this study, patients with operation incurred lower lifetime treatment costs than patients with CTx/RTx or supportive treatment, indicating that the economic burden of lung cancer was affected by treatment method. Further studies including both cancer stage and treatment modality are needed to confirm these results and to provide more information on the economic burden according to disease severity.

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Recent trends in economic burden of acute myocardial infarction in South Korea.

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