Costs and Medical Care Consequences Associated with the Diagnosis of Peripheral Arterial Disease
J. Jaime Caro
Khajak J. Ishak
Judith A. O'Brien
Background: Peripheral arterial disease (PAD) is increasingly recognised as an indicator of disseminated atherothrombosis, but its impact on use of healthcare resources is not well understood. Objective: To provide a quantitative description of the resource utilisation and costs incurred following PAD. Methods: Hospitalisations, physician visits and the corresponding direct medical costs were examined in 16_440 patients with a diagnosis of PAD (1985-1995) in Saskatchewan, Canada, and compared with 15_590 reference patients with a diagnosis of myocardial infarction (MI) [1990-1995]. Medical history and patient characteristics were available retrospectively to January 1980 and follow-up to December 2000. Rates and timing of all-cause and cardiovascular hospitalisations and physician visits within discrete periods in the 10 years following PAD diagnosis, and 5 years following MI, were evaluated, as were lengths of stay and predictors of hospitalisation. Results: Average follow-up was 5.9 years among patients with PAD and 3.6 years for MI. Half (55%) of patients with PAD were male versus 64% of reference patients. The mean ages were 67.3 and 66.9 years, respectively. Patients with PAD were hospitalised most frequently soon after diagnosis, with rates subsequently decreasing to 0.14 per month. These rates were similar in the reference group except for the period immediately following MI. The average 5-year cost post-diagnosis (2002 $Can) per patient was $Can41_968 vs $Can48_578 for the reference population. Conclusions: A diagnosis of PAD not only imposes a severe burden on patients and their families, but it also significantly increases the use of healthcare resources and the associated costs. By the end of year 1, this burden is comparable with a diagnosis of MI.
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