Societal costs of non-cardiac chest pain
2013 (English)Conference paper, Poster (Other academic)
Introduction: More than 50 % of patients suffering from acute chest pain are diagnosed with non-cardiac chest pain (NCCP). These patients often seek care due to recurrent chest pain and psychological distress due to worries about suffering from an undetected serious disease. Patients with NCCP use outpatient health-care to the same extent as cardiac patients. There is no research on the societal costs of patients with NCCP.
Purpose: To describe the societal costs of patients with NCCP in relation to patients with acute myocardial infarction (AMI) and angina pectoris (AP) in Sweden.
Methods: A longitudinal descriptive design was used, including 199 patients (99 with NCCP, 51 with AMI and 49 with AP). Patients had a mean age of 67 years and 59% were men. Data regarding health-care utilization and societal costs was collected one year before including index admission and one year after. Societal costs comprised direct health-care costs within primary, outpatient and hospital care, and indirect costs due to production loss because of sick-leave and disability. To obtain data, we used a regional care-database for health-care utilization, the cost-per-patient database for direct costs, and the social insurance office database for indirect costs.
Results: Patients with NCCP, AMI, and AP had on average 54, 50 and 65 primary care contacts and 3, 4 and 4 hospital admissions respectively during the two years. All groups had significantly more primary care contacts, but fewer admissions the year after index admission compared to the year of the index admission. Patients with NCCP, AMI, and AP had a length of stay of 6, 11 and 11 days respectively during the two years. Patients with AMI and AP had significantly longer hospital stay the year after the index admission than the year of the index admission. On average 14, 18, and 25 % of the patients with NCCP, AMI and AP were on sick-leave annually, and about 12 % of patients per group were receiving disability pension. The mean annual societal cost of patients with NCCP, AMI and AP were approximately € 9500, € 15000 and € 14000 per patient.
Conclusion and implications: All participants utilized a significant amount of health-care and were substantially absent from work. The annual societal cost of patients with NCCP was the lowest of the three groups. But due to high prevalence of NCCP, the cumulative annual national cost of these patients could be more than double as for AMI and AP. Targeted interventions based on psycho-educational support to patients with NCCP to help them handle their chest pain and thereby reduce health-care utilization and costs are needed.
Place, publisher, year, edition, pages
, European Journal of Cardiovascular Nursing, ISSN 1474-5151
Non-cardiac chest pain, ischemic heart disease, health-care utilization, societal costs, direct costs, indirect costs
Other Medical Sciences
IdentifiersURN: urn:nbn:se:liu:diva-90450OAI: oai:DiVA.org:liu-90450DiVA: diva2:613368
EuroHeartCare, 22-23 March 2013, Glasgow, United Kingdom