Establishing a cost estimation model for hypertension and its related diseases in Taiwan

Chronic diseases are responsible for significant economic losses related to direct costs of medical care, as well as indirect costs arising from lost productivity. To optimize the use of limited health care resources, there is a need to establish a comprehensive index to establish the priorities for funding of health programs for chronic diseases. In this study, we applied the population attributable risk proportion (PAR) model to estimate the economic burden imposed by hypertension and its related diseases in Taiwan in 1991. Data were collected from published statistical reports and research reports. The estimated total economic cost of hypertension and associated diseases was 9.0 to 11.9 billion New Taiwan dollars (NTD) in 1991 (1 US dollar was equivalent to 27 NTD in 1991). Direct costs were the largest component of total expenditure (5.4-7.1 billion NTD), followed by morbidity costs (3.2 billion NTD), and mortality costs (0.4-1.5 billion NTD). Categorized by disease type, hypertensive diseases accounted for the largest share of costs (6.8-7.7 billion NTD), followed by cerebrovascular diseases (1.0-1.9 billion NTD). Disorders of arteries, arterioles, and capillaries accounted for the smallest share (41 million to 1 billion NTD). The method used in this study provides a satisfactory estimation of the economic burden imposed by hypertension and related diseases, and can be applied to other risk factors or diseases to show their separate economic impacts. The precision of such estimates can be greatly improved if health authorities establish more complete databanks to collect data on national expenditure for all types of health care services. This would, in turn, provide policy makers with more accurate data on which to base allocation of funding for chronic disease health care programs.