Prevalence and economic burden of cardiovascular diseases in France in 2013 according to the national health insurance scheme database

Arch Cardiovasc Dis. 2016 Jun-Jul;109(6-7):399-411. doi: 10.1016/j.acvd.2016.01.011. Epub 2016 Apr 11.

Abstract

Background: Cardiovascular diseases (CVDs) constitute the second leading cause of death in France. The Système national d'information interrégimes de l'assurance maladie (SNIIRAM; national health insurance information system) can be used to estimate the national medical and economic burden of CVDs.

Objectives: To describe the rates, characteristics and expenditure of people reimbursed for CVDs in 2013.

Methods: Among 57 million general health scheme beneficiaries (86% of the French population), people managed for CVDs were identified using algorithms based on hospital diagnoses either during the current year (acute phase) or over the previous 5 years (chronic phase) and long-term diseases. The reimbursed costs attributable to CVDs were estimated.

Results: A total of 3.5 million people (mean age, 71 years; 42% women) were reimbursed by the general health scheme for CVDs (standardized rate, 6.5%; coronary heart disease, 2.7%; arrhythmias/conduction disorders, 2.1%; stroke, 1.1%; heart failure, 1.1%). These frequencies increased with age and social deprivation, and were higher in Northern and Eastern France and Réunion Island. The total sum reimbursed by all schemes for CVDs was € 15.1 billion (50% for hospital care and 43% for outpatient care [including 15% for drugs and 12% for nurses/physiotherapists]); coronary heart disease accounted for € 4 billion, stroke for € 3.5 billion and heart failure for € 2.5 billion (i.e. 10% of the total expenditure reimbursed by all national health insurance schemes for all conditions).

Conclusion: CVDs constitute the leading group in terms of numbers of patients reimbursed and total reimbursed expenditure, despite a probable underestimation of both numbers and expenditure.

Keywords: Cardiovascular diseases; Comorbidities; Comorbidités; Costs; Coûts; Maladies cardiovasculaires; Prevalence; Prévalence; SNIIRAM; Sniiram.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Algorithms
  • Ambulatory Care / trends
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / economics*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / therapy
  • Child
  • Child, Preschool
  • Comorbidity
  • Data Mining
  • Databases, Factual
  • Drug Costs / trends
  • Female
  • France / epidemiology
  • Health Care Costs / trends*
  • Health Expenditures / trends*
  • Hospital Costs / trends
  • Humans
  • Infant
  • Infant, Newborn
  • Insurance, Health, Reimbursement / trends*
  • Male
  • Middle Aged
  • National Health Programs / economics*
  • Prevalence
  • Time Factors
  • Young Adult