What is the clinical evidence from this study?

Study design: Cohort. Population: Non-cardiac chest pain, acute myocardial infarction, and angina pectoris (n=199). Intervention: Non-cardiac chest pain vs. Acute myocardial infarction and angina pectoris. Primary outcome: Mean annual societal costs per patient (Euros).

October 9, 2013Open Access

Societal costs of non-cardiac chest pain compared with ischemic heart disease - a longitudinal study

GMGhassan MouradLinköping University JAJenny AlwinLinköping University ASAnna StrömbergHeart Failure & Transplant

Key Result

The mean annual societal cost of patients with non-cardiac chest pain was €10,068, which was lower than the costs for patients with acute myocardial infarction (€15,989) and angina pectoris (€14,737).

Study Design

Type

Cohort (n=199)

Multicenter

Structured PICO

Population

199 patients admitted for acute chest pain and diagnosed with non-cardiac chest pain, acute myocardial infarction, or angina pectoris, followed for 2 years to assess societal costs.

Outcome

Annual societal costs, including direct healthcare costs and indirect costs due to productivity loss

Although individual societal costs for non-cardiac chest pain are lower than for ischemic heart disease, the high prevalence of the condition results in a substantial cumulative economic burden.

Main Result

Absolute Event Rate: 10068% vs 15989%

Limitations

Costs related to pain and suffering, family members caring for the individual, or home care services were not included.
Sick-leave periods shorter than 15 days were not registered, potentially underestimating indirect costs.
Including all healthcare costs, even those not directly related to the diagnoses, may cause a slight over-estimation of costs.

Abstract

BACKGROUND: Non-cardiac chest pain (NCCP) is a common complaint. Our aim was to present a detailed description of the costs of patients with NCCP compared to patients with acute myocardial infarction (AMI) and Angina Pectoris (AP) from a societal perspective. METHODS: Data on healthcare utilization and annual societal costs, including direct healthcare costs and indirect costs due to productivity loss, were collected from different databases. The participants consisted of 199 patients from a general hospital in Sweden (99 with NCCP, 51 with AMI, 49 with AP), mean age of 67 years, 59% men. RESULTS: NCCP, AMI, and AP patients had on average 54, 50 and 65 primary care contacts and 3, 4, and 4 hospital admissions during a period of 2 years. Length of hospital stay was 6, 11 and 11 days. On average, 14%, 18%, and 25% of NCCP, AMI and AP patients were on sick-leave annually, and about 12% in each group received a disability pension. The mean annual societal costs of NCCP, AMI and AP patients were €10,068, €15,989 and €14,737. CONCLUSIONS: Although the annual societal cost of NCCP patients was lower than in AMI and AP patients, the cost was still considerable (€10,068). Taken into account the high prevalence of NCCP, the cumulative annual national cost of these patients could be more than the double of AMI and AP if all patients incurred the same costs as in this study. Targeted interventions are important in order to support patients with NCCP and minimize healthcare utilization and costs.

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