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Multicenter Study
. 2025 Jan 16;11(1):37-46.
doi: 10.1093/ehjqcco/qcae014.

Health care utilization and the associated costs attributable to cardiovascular disease in Ireland: a cross-sectional study

Danko Stamenic  1 , Anthony P Fitzgerald  1   2 , Katarzyna A Gajewska  1   3 , Kate N O'Neill  1 , Margaret Bermingham  4 , Jodi Cronin  5 , Brenda M Lynch  5 , Sarah M O'Brien  6 , Sheena M McHugh  1 , Claire M Buckley  1   7 , Paul M Kavanagh  8   9 , Patricia M Kearney  1   7 , Linda M O'Keeffe  1   10   11
Affiliations
Multicenter Study

Health care utilization and the associated costs attributable to cardiovascular disease in Ireland: a cross-sectional study

Danko Stamenic et al. Eur Heart J Qual Care Clin Outcomes. .

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of mortality and disability globally. We examined healthcare service utilization and costs attributable to CVD in Ireland in the period before the introduction of a major healthcare reform in 2016.

Methods: Secondary analysis of data from 8113 participants of the first wave of The Irish Longitudinal Study on Ageing. Cardiovascular disease was defined as having a self-reported doctor's diagnosis of myocardial infarction, angina, heart failure, stroke, atrial fibrillation, or transient ischaemic attack. Participants self-reported the utilization of healthcare services in the year preceding the interview. Negative binomial regression with average marginal effects (AMEs) was used to estimate the incremental number of general practitioner (GP) and outpatient department (OPD) visits, accident and emergency department attendances and hospitalizations in population with CVD relative to population without CVD. We calculated the corresponding costs at individual and population levels, by gender and age groups.

Results: The prevalence of CVD was 18.2% (95% CI: 17.3, 19.0) Participants with CVD reported higher utilization of all healthcare services. In adjusted models, having CVD was associated with incremental 1.19 [95% confidence interval (CI): 0.99, 1.39] GP and 0.79 (95% CI: 0.65, 0.93) OPD visits. There were twice as many incremental hospitalizations in males with CVD compared to females with CVD [AME (95% CI): 0.20 (0.16, 0.23) vs. 0.10 (0.07, 0.14)]. The incremental cost of healthcare service use in population with CVD was an estimated €352.2 million (95% CI: €272.8, €431.7), 93% of which was due to use of secondary care services.

Conclusion: We identified substantially increased use of healthcare services attributable to CVD in Ireland. Continued efforts aimed at CVD primary prevention and management are required.

Keywords: Cardiovascular disease; Direct costs; Healthcare use; Ireland.

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Figures

Figure 1
Figure 1
A flow diagram of participant inclusion in the TILDA study.
Figure 2
Figure 2
Incremental use of healthcare services attributable to CVD and associated costs stratified by gender. Legend: (A) Average marginal effects of CVD on healthcare services use, (B) cost per person of incremental healthcare services use attributable to CVD, and (C) population-level costs of incremental healthcare services use attributable to CVD. Estimates are given with 95% CI. CVD, cardiovascular disease; AME, average marginal effect; CI, confidence intervals; GP, general practitioner; OPD, outpatient department; A&E, accident & emergency department; and Hosp, hospital admissions.
Figure 3
Figure 3
Incremental use of healthcare services attributable to CVD and associated costs stratified by age group. Legend: (A) Average marginal effects of CVD on healthcare services use, (B) cost per person of incremental healthcare services use attributable to CVD, and (C) population-level costs of incremental healthcare services use attributable to CVD. Estimates are given with 95% CI. CVD, cardiovascular disease; AME, average marginal effect; CI, confidence intervals; GP, general practitioner; OPD, outpatient department; A&E, accident & emergency department; and Hosp, hospital admissions.
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References

    1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard Met al. . Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet North Am Ed 2020;396:1204–1222. - PMC - PubMed
    1. Ritchie H, Spooner F, Roser M. Causes of death Our World in Data 2018; Available from: https://ourworldindata.org/causes-of-death.
    1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LMet al. . Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol 2020;76:2982–3021. - PMC - PubMed
    1. Luengo-Fernandez R, Walli-Attaei M, Gray A, Torbica A, Maggioni AP, Huculeci Ret al. . Economic burden of cardiovascular diseases in the European Union: a population-based cost study. Eur Heart J 2023;44:4752–4767. - PMC - PubMed
    1. Luengo-Fernandez R, Little M, Gray A, Torbica A, Maggioni AP, Huculeci Ret al. . Cardiovascular disease burden due to productivity losses in European Society of Cardiology countries. European Heart Journal—Quality of Care and Clinical Outcomes 2024;10:36–44. - PMC - PubMed

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