Cost of illness for chronic stable angina patients enrolled in a self-management education trial
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Michael H McGillion1, Ruth Croxford, Judy Watt-Watson
1Faculty of Nursing, University of Toronto, Toronto, Canada. michael.mcgillion@utoronto.ca
Insights
Chronic stable angina (CSA) significantly burdens Canada
Area of Science:
- Cardiovascular Health
- Health Economics
- Patient Self-Management
Background:
- Chronic stable angina (CSA) is a significant health issue in Canada.
- Limited data exists on the economic impact of CSA interventions.
- Understanding CSA's economic burden is crucial for healthcare planning.
Purpose of the Study:
- To assess the short-term economic impact of a self-management training program for CSA.
- To estimate the total societal cost of CSA per patient annually.
Main Methods:
- A clinical trial involving 117 CSA patients.
- Cost data collected pre- and post-intervention using the Ambulatory Home Care Record.
- Annualized direct, indirect, and system costs were calculated from a societal perspective.
Main Results:
- The self-management program showed no short-term impact on CSA costs.
- Annual direct costs averaged $3,267 per patient.
- Annual indirect costs (unpaid care time) were substantial at $12,963.
- Total estimated annual societal cost of CSA was $19,209 per patient.
Conclusions:
- CSA represents a major economic burden in Canada, similar to chronic noncancer pain.
- Further research into self-management training is needed to mitigate CSA's economic impact.
- Developing effective interventions can reduce the significant financial strain of CSA.
Background:
Chronic stable angina (CSA) is a major debilitating health problem in Canada. A paucity of relevant cardiovascular data sets has precluded a detailed examination of the impact of interventions on CSA-related costs and its broader economic burden.
Objectives:
As part of a larger clinical trial, the authors sought to determine the short-term impact of a standardized self-management training program on CSA-related costs. A secondary objective was to estimate the total annualized cost of CSA per patient from a societal perspective.
Methods:
Pre- and three-month post-test cost data were collected on 117 participants using the Ambulatory Home Care Record. Mean annualized direct, indirect and system-related CSA costs (2003 to 2005) were estimated; total per-patient CSA costs from a societal perspective were calculated as the sum of these costs.
Results:
The mean (+/- SD) age of participants was 68+/-11 years; 80% were male. The program did not impact costs in the short-term. Direct annual out-of-pocket costs, including money paid for health care, travel to appointments, medication, equipment and home support totaled $3,267. Indirect costs, reflecting the value of all unpaid time spent by those engaged in angina-related care, were $12,963. System costs, including costs paid by public and private insurers, were $2,979. Total estimated annual CSA costs from a societal perspective were $19,209 per patient.
Conclusions:
These data suggest that CSA imposes a major economic burden, comparable with other prevalent conditions such as chronic noncancer pain. Advancements in self-management training research are needed to help reduce the economic burden of CSA in Canada.
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