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European Heart Journal 1997 18(7):1102-1109;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

An economic analysis of ischaemic heart disease in Switzerland

M. Sagmeister*,{dagger}, U. Gessner{dagger}, W. Oggier{dagger}, B. Horisberger{dagger} and F. Gutzwiller{ddagger}

*Department of Internal Medicine, University Hospital Zurich Zurich, Switzerland
{dagger}Research Group for Management in Health Services, University of St. Gallen St. Gallen, Switzerland
{ddagger}Institute of Social and Preventive Medicine, University of Zurich Zurich, Switzerland

revised 17 December 1996; accepted 29 January 1997.

Correspondence: M. Sagmeister MD. Clinic A, Department of Internal Medicine, University Hospital Zurich CH-8091 Zurich, Switzerland

Abstract

AIMS: Direct and indirect costs of ischaemic heart disease were assessed in Switzerland, for the period 1988–1993, in order to evaluate the economic consequences of more intensive treatment of the disease and of the decreasing mortality from ischaemic heart disease in the working population.

METHODS AND RESULTS: A societal perspective was taken for a prevalence-based assessment of the direct (total resources consumed by outpatients and inpatients) and indirect (due to morbidity, invalidity, and premature death, using the human capital approach) costs. The results showed the total costs were 21 million US dollars per 100 000 population in the year 1993 (47% direct, 53% indirect costs). The largest components were the direct costs of inpatient care and indirect costs due to premature death (each approximately 25% of the total). Trends showed a large increase in direct costs (+9% per year, constant dollars). Indirect costs stabilized or decreased slightly due to the reduction of work losses.

CONCLUSIONS: Today's medicine and preventive measures have proven effective for ischaemic heart disease, although such remedies have required increasingly large financial resources. However, society benefits because indirect costs decrease, although this gain does not compensate for all direct costs.

Key Words: Ischaemic heart disease • mortality • direct costs • indirect costs • gain to society • Switzerland


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