Long-term healthcare use and costs in patients with stable coronary artery disease: a population-based cohort using linked health records (CALIBER)
Year: 2016
Type: article
Study design: Observational Study
Abstract: AIMS: To examine long-term healthcare utilization and costs of patients with stable coronary artery disease (SCAD). METHODS AND RESULTS: Linked cohort study of 94 966 patients with SCAD in England, 1 January 2001 to 31 March 2010, identified from primary care, secondary care, disease, and death registries. Resource use and costs, and cost predictors by time and 5-year cardiovascular disease (CVD) risk profile were estimated using generalized linear models. Coronary heart disease hospitalizations were 20.5% in the first year and 66% in the year following a non-fatal (myocardial infarction, ischaemic or haemorrhagic stroke) event. Mean healthcare costs were £3133 per patient in the first year and £10 377 in the year following a non-fatal event. First-year predictors of cost included sex (mean cost £549 lower in females), SCAD diagnosis (non-ST-elevation myocardial infarction cost £656 more than stable angina), and co-morbidities (heart failure cost £657 more per patient). Compared with lower risk patients (5-year CVD risk 3.5%), those of higher risk (5-year CVD risk 44.2%) had higher 5-year costs (£23 393 vs. £9335) and lower lifetime costs (£43 020 vs. £116 888). CONCLUSION: Patients with SCAD incur substantial healthcare utilization and costs, which varies and may be predicted by 5-year CVD risk profile. Higher risk patients have higher initial but lower lifetime costs than lower risk patients as a result of shorter life expectancy. Improved cardiovascular survivorship among an ageing CVD population is likely to require stratified care in anticipation of the burgeoning demand.
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $2,827
Funders: National Institute for Social Care and Health Research, Wellcome Trust, Cancer Research UK, National Institute for Health and Care Research, British Heart Foundation, University College London, Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council
Awards: Dynamic clinical risk predictions in personalised medicine: development and application of joint models for repeatedly measured biomarkers and time-to-event data in biomedical research., Clinical Trials Fellowship, G2107972360, G2649216232, Differential leukocyte counts and the prognosis of specific coronary phenotypes., G3063934243, Improving the quality of care of patients with angina and heart attack, G4457630332, G5010676993, Higher resolution cardiovascular epidemiology: unique insights from linking the national cardiac event register with primary care records and highly phenotyped cohorts., G5796606410, NIHR Senior Investigator Award, Differential leukocyte counts and the prognosis of specific coronary phenotypes., Developing Economic Evaluation Methods for Decision Making: The Value of Access to Individual Patient Data, G7133998767, E-Infrastructure Interconnectivity EPSRC - Chris Taylor, Higher resolution cardiovascular epidemiology: unique insights from linking the national cardiac event register with primary care records and highly phenotyped cohorts.
OpenAlex ID: W2277056561