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Costs and medical care consequences associated with the diagnosis of peripheral arterial disease

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Abstract

Background: Peripheral arterial disease (PAD) is increasingly recognised as an indicator of disseminated atherothrombosis, but its impact on use of healthcare resources is not well understood.

Objective: To provide a quantitative description of the resource utilisation and costs incurred following PAD.

Methods: Hospitalisations, physician visits and the corresponding direct medical costs were examined in 16 440 patients with a diagnosis of PAD (1985–1995) in Saskatchewan, Canada, and compared with 15 590 reference patients with a diagnosis of myocardial infarction (MI) [1990–1995]. Medical history and patient characteristics were available retrospectively to January 1980 and follow-up to December 2000. Rates and timing of all-cause and cardiovascular hospitalisations and physician visits within discrete periods in the 10 years following PAD diagnosis, and 5 years following MI, were evaluated, as were lengths of stay and predictors of hospitalisation.

Results: Average follow-up was 5.9 years among patients with PAD and 3.6 years for MI. Half (55%) of patients with PAD were male versus 64% of reference patients. The mean ages were 67.3 and 66.9 years, respectively. Patients with PAD were hospitalised most frequently soon after diagnosis, with rates subsequently decreasing to 0.14 per month. These rates were similar in the reference group except for the period immediately following MI. The average 5-year cost post-diagnosis (2002 $Can) per patient was $Can41 968 vs $Can48 578 for the reference population.

Conclusions: A diagnosis of PAD not only imposes a severe burden on patients and their families, but it also significantly increases the use of healthcare resources and the associated costs. By the end of year 1, this burden is comparable with a diagnosis of MI.

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Acknowledgements

This study is based in part on de-identified data provided by the Saskatchewan Department of Health. The interpretation and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Department of Health.

This work was supported in part by a grant from Sanofi-Synthelabo and Bristol-Myers Squibb to Caro Research. The grantors collaborated in helping set the specifications for the example but had no role in methodological decisions or interpretation of results. They were also allowed to review and comment on this manuscript but were explicitly forbidden from exerting any editorial control. Expenses for travel to present the findings at the European Society of Cardiology Annual Meeting, Vienna, 31 August 2003 were reimbursed. The authors are employees of Caro Research, a consultancy that has also received grants for other, unrelated, research from other pharmaceutical companies.

K. Migliaccio-Walle and J. Jaime Caro conceived the study, designed the analyses and wrote the paper; K. Ishak helped design the analyses, carried out all the analyses and helped write the paper; J.A. O’Brien developed the cost estimates and helped write the paper.

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Authors and Affiliations

  1. Caro Research Institute, Boston, Massachusetts, USA

    Kristen Migliaccio-Walle, J. Jaime Caro & Judith A. O’Brien

  2. Division of General Internal Medicine, McGill University, Montreal, Quebec, Canada

    J. Jaime Caro

  3. Caro Research Institute, Montreal, Quebec, Canada

    Khajak J. Ishak

Authors
  1. Kristen Migliaccio-Walle
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  2. J. Jaime Caro
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  3. Khajak J. Ishak
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  4. Judith A. O’Brien
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Correspondence to J. Jaime Caro.

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Migliaccio-Walle, K., Caro, J.J., Ishak, K.J. et al. Costs and medical care consequences associated with the diagnosis of peripheral arterial disease. Pharmacoeconomics 23, 733–742 (2005). https://doi.org/10.2165/00019053-200523070-00007

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