Table 23-1.
Estimated Direct and Indirect Costs (in Billions of Dollars) of CVD and Stroke: United States, 2008
| Heart Disease* | Stroke | Hypertensive Disease† | Other Circulatory Conditions | Total Cardiovascular Disease | |
|---|---|---|---|---|---|
| Direct costs‡ | |||||
| Hospital inpatient stays | 54.0 | 9.1 | 6.2 | 10.4 | 79.7 |
| Hospital emergency department visits | 7.3 | 0.9 | 1.7 | 0.9 | 10.8 |
| Hospital outpatient or office-based provider visits | 16.9 | 1.8 | 13.0 | 4.7 | 36.4 |
| Home health care | 7.6 | 5.8 | 5.1 | 0.9 | 19.4 |
| Prescribed medicines | 9.7 | 1.2 | 21.3 | 0.7 | 32.9 |
| Total expenditures | 95.5 | 18.8 | 47.3 | 17.6 | 179.2 |
| Indirect costs§ | |||||
| Lost productivity/mortality|| | 94.8 | 15.5 | 3.3 | 4.9 | 118.5 |
| Grand totals | 190.3 | 34.3 | 50.6 | 22.5 | 297.7 |
CVD indicates cardiovascular disease.
Numbers do not add to total because of rounding.
This category includes coronary heart disease, heart failure, part of hypertensive disease, cardiac dysrhythmias, rheumatic heart disease, cardiomyopathy, pulmonary heart disease, and other or ill-defined heart diseases.
Costs attributable to hypertensive disease are limited to hypertension without heart disease.
Medical Expenditure Panel Survey healthcare expenditures are estimates of direct payments for care of a patient with the given disease provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs are not included. These estimates of direct costs do not include payments attributed to comorbidities. Total cardiovascular disease costs are the sum of costs for the 4 diseases but with some duplication.
The Statistics Committee agreed to suspend presenting estimates of lost productivity attributable to morbidity until a better estimating method can be developed.
Lost future earnings of persons who died in 2008, discounted at 3%.
Sources: Estimates from the Household Component of the Medical Expenditure Panel Survey of the Agency for Healthcare Research and Quality for direct costs (2008).1 Indirect mortality costs are based on 2008 counts of deaths by the National Center for Health Statistics and an estimated present value of lifetime earnings furnished for 2007 by Wendy Max (Institute for Health and Aging, University of California, San Francisco, 2011) and inflated to 2008 from change in worker compensation reported by the Bureau of Labor Statistics.5
All estimates prepared by Thomas Thom and Michael Mussolino, National Heart, Lung, and Blood Institute.