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Scandinavian Journal of Public Health, Vol. 36, No. 8, 850-856 (2008)
DOI: 10.1177/1403494808095955

Costs of heart disease and risk behaviour: Implications for expenditure on prevention

Marie Kruse

National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark, mak{at}niph.dk

Michael Davidsen

National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

Mette Madsen

Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

Dorte Gyrd-Hansen

Institute of Public Health, University of Southern Denmark, Odense Denmark and Danish Institute for Health Services Research, Copenhagen, Denmark

Jan Sørensen

Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, Odense, Denmark

Aims: The objective of this paper is firstly to estimate the healthcare costs attributable to heart disease in Denmark using recently available data for 2002—05. Secondly, to estimate the attributable healthcare costs of lifestyle risk factors among heart patients, in order to inform decision making about prevention programmes specifically targeting patients with heart disease. Methods: For a cohort consisting of participants in a national representative health interview survey, register-based information about hospital diagnosis was used to identify patients with heart disease. Healthcare consumption during 2002— 05 among individuals developing heart disease during 2002—05 was compared with individuals free of heart disease. Healthcare costs attributable to heart disease were estimated by linear regression with adjustment for confounding factors. The attributable costs of excess drinking, physical inactivity and smoking among future heart patients were estimated with the same method. Results: Individuals with heart disease cost the healthcare system on average 3195 (p<0.0001) per person-year more than individuals without heart disease. The attributable cost of unhealthy lifestyle factors among individuals at risk of heart disease was about 11%—16% of the attributable cost of heart disease. Conclusions: Heart disease incurs significant additional costs to the healthcare sector, and more so if heart patients have a history of leading an unhealthy life. Consequently, strategies to prevent or cease unhealthy lifestyle may not only result in cost savings due to avoided heart disease. Additional cost savings may be obtained because heart patients who prior to the disease led a more healthy life consume fewer healthcare resources.

Key Words: Attributable costs • excess drinking • heart disease • physical inactivity • prospective cohort analysis • smoking


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