[Venous disease in France: an unrecognized public health problem]

Different reasons explain that chronic venous insufficiency remains ill recognized as a public health problem in France: very few epidemiologic studies have been undertaken in this pathology; this disease is very heterogeneous in terms of gravity and clinical evidence: from isolated symptoms to localized clinical signs, with or without severe complications. Clinical semiology is actually not standardised. The analysis of available informations suggests that this pathology represents approximatively 2.6% of the whole health expenditures in France, that is to say an amount of 14.7 billion of Francs for the year 1991. The number of patients suffering from chronic venous insufficiency can be estimated to about 11 millions, whose 7 millions present symptomatic signs (leg heaviness, pain, moderate edema). The number of hospitalizations is around 200,000 per year, of which 63% are in surgery in private clinics. One half of these hospital stays concerned varicose veins (the 8th cause of hospitalization in France). Forty of the patients consulting for chronic venous insufficiency are at work and about 7 to 8% of them get sick leaves for this pathology: around 362,000 sick leaves per year representing 6.4 millions of day lost. On the basis of the medical consumption survey performed by INSEE/CREDES, an extrapolation was made to estimate the different components of costs of chronic venous insufficiency: 41% (drugs), 34% (hospital care) and 13% (medical fees).