Direct medical costs of cardiovascular diseases: Do cost components vary according to sex and age?

PLoS One. 2024 Oct 10;19(10):e0311599. doi: 10.1371/journal.pone.0311599. eCollection 2024.

Abstract

Background: The aim was to estimate direct medical costs of men and women patients by age group related to cardiovascular diseases (coronary heart disease, strokes) in the province of Quebec, Canada from the economic perspective of the healthcare public system, encompassing five cost components: physician fees, hospitalization (hospital stay, intensive care stay), emergency visits and medication costs.

Methods: This matched case-control study involved secondary data from a longitudinal cohort study (1997-2018) of 4584 white-collar workers. Participants were followed for a four-year period. We used an incremental cost method of difference-in-difference. Descriptive analyses using frequency counts, arithmetic means, standardized differences, chi-squared tests, and Student's T-tests were performed. Direct medical costs were estimated using mean and 95% bootstrap confidence interval.

Results: Direct medical costs per case were CAD $4970 [4344, 5595] for all in the first year after the event. For men patients, direct medical costs were $5351 [4649, 6053] and $4234 [2880, 5588] for women in the first year after the event, $221 [-229, 671] for men and $226 [-727, 1179] for women in the second year, and $11 [-356, 377] for men and $-24 [-612, 564] for women in the third year. This decrease was observed for both men and women, with higher costs for men. Within the first year, physician fees dominated CVD-associated costs among both men and women cases younger than 65. However, hospital stay represented the costliest component among cases aged 65 and older, incurring higher costs in women compared to men. In the subsequent years, the distribution of costs showed variations according to sex and age, with either medication costs or physician fees being the predominant components, depending on the specific subgroups.

Conclusions: CVD-associated direct medical costs varied by components, sex, age, and follow-up years. Patients with CVD incurred more than twice the medical costs as compared to patients without CVD of same age and sex.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cardiovascular Diseases* / economics
  • Cardiovascular Diseases* / epidemiology
  • Case-Control Studies
  • Female
  • Health Care Costs* / statistics & numerical data
  • Hospitalization* / economics
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Quebec / epidemiology
  • Sex Factors

Grants and funding

This study was funded by a grant from the Canadian Institute of Health Research. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, and writing this manuscript. Information provided in this article is the responsibility of the authors only.