Current Trends in Medical Economics in the Circulatory Field - Socioeconomics Background and Research Issue

Abstract

Background: Circulatory diseases now comprise a larger share of medical expenses, accounting for 19.7% (2016) of total national health expenditure. Medical economics is an area of study encompassing medical science and economics that deals with a wide variety of topics and issues related to the medical and health-care field. Methods and Results: In order to discuss the relationship between medical costs and research activities, this article conducted a correlation analysis of the ratio of national health expenditures to gross domestic product (GDP) and the number of medical economics articles in the circulatory field. A comparison of the ratios of national health expenditure and of the number of medical economics articles indicates that the number of articles increased as the ratio of the expenditure increased and vice versa with a slight time lag (r²=0.964, P<0.01). Medical economics will explore deeply the subjects related to the clinical and economy in the circulatory field in the future, with due consideration of these diverse backgrounds. Conclusions: Lively and in-depth future-oriented discussions of medical economics topics will facilitate the construction of valuable evidence that will help many personnel engaged in medical sites to gain new insights into clinical services, in addition to promoting the development of the healthcare system.

Keywords: Circulatory disease; Correlation analysis; Innovative medical technology; Medical economics; National health expenditure.

Figure 1.

Annual ratio of the number of medical economics articles in the circulatory field to the total number of the articles in the same field and the ratio of the total national health expenditures to gross domestic product (GDP; Organization for Economic Cooperation and Development [OECD] and G20 countries: data lacking for some countries in the 1980 s). (G20: United States, United Kingdom, France, Germany, Japan, Italy, Canada, EU, Russia, China, India, Brazil, Mexico, South Africa, Australia, South Korea, Indonesia, Saudi Arabia, Turkey, Argentina) Total national health expenditure was estimated based on “Health Expenditure as a Percent of Gross Domestic Product: OECD statistics from 1985 to 2017”. The number of medical economics articles in the circulatory field was estimated based on a PubMed search (1985–2017). (Search keywords: Circulation AND Health economics [OR: Cost-effectiveness, Medical economics, Economic evaluation, Socioeconomics]). Reproduced with permission from Takura T, 2018.

Figure 2.

Structure of the main subjects in health economics (medical economics in the broad sense). (Modified with permission from original reported (Figure 2) by Takura T.¹) ICT, information and communication technology.

Figure 3.

Case: cost-effectiveness analysis of medical equipment (drug-eluting stent, percutaneous coronary intervention [PCI]). According to prospective cohort and modeling calculations, PCI for stable ischemic heart disease in Japan is a potential cost-effective option. In contrast, it is important to identify the study population (scope) for cost-effectiveness evaluation of medical devices. FFR, fractional flow reserve; QALY, quality adjusted life years. (Reproduced with permission from Takura T, 2017.¹²)

Figure 4.

Consultation: Trial arrangement about the transition of the total medical expenses (budget allocation) and the average reimbursement claim (unit price) by disease area (excluding surgical). This arrangement suggests adjusting the level of reimbursement claim according to the demand within limited medical resource (budget) constraints. In the management of reimbursement claim and medical insurance, the relationship of “price×quantity=total budget (allocation adjustment)” can be seen. It is what we call the influence of balanced finance. (Reproduced with permission from Takura T, 2014.¹³)