TY - JOUR
T1 - Direct economic burden of acute coronary syndromes in the Portuguese National Health Service
T2 - facts and trends between 2002 and 2022
AU - Madeira, Francisco
AU - Martins, Carla
AU - Viegas, Susana
AU - Timóteo, Ana Teresa
AU - Loureiro, Fátima
AU - Perelman, Julian
N1 - Funding Information:
The author(s) declare that financial support was received for the research and/or publication of this article. This work was funded by Foundation for Science and Technology/Ministry of Science, Technology and Higher Education, through national funds to PMCardImpact (EXPL/SAU-PUB/0944/2021).
Publisher Copyright:
Copyright © 2025 Madeira, Martins, Viegas, Timóteo, Loureiro and Perelman.
PY - 2025
Y1 - 2025
N2 - Aim: We estimated the average direct cost per Acute Coronary Syndromes (ACS) in-patient episodes by diagnosis, namely ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA), and undetermined AMI (Acute Myocardial Infarction). We also analyzed the changes in direct costs over time between 2002 and 2022, and the total direct economic burden of ACS hospitalizations for the Portuguese National Health Service (NHS). Methods: We used the Portuguese Registry of Acute Coronary Syndromes (61,440 ACS hospitalizations), a cohort of people with ACS, recruited and followed from first hospitalization. A direct cost analysis was conducted. As resources, we considered health professional working hours, non-medical resources used during in-patient stays, laboratory and diagnostic tests, interventional cardiology procedures, pharmaceuticals, hospitalization-related complications, rehabilitation services, and death costs. A multivariate analysis was performed to identify the main cost determinants. Results: The average cost per ACS patient from 2002 to 2022 was 6,280.79 €. A significantly higher average cost was observed among patients diagnosed with STEMI of 3,853.26€ (95% confidence interval [CI] 3,690.87 to 4,015.65€), among NSTEMI patients of 1,308.91 € (95% CI 1,173.52 € to 1,444.30 €), and among patients who died during the hospitalization of 12,017.64€ (95% CI 11,232.21 € to 12,803.08 €). Over time, cost trends fluctuated, increasing until 2011 and then gradually decreasing until 2022, apart from 2020. Considering the total universe of 294,307 ACS-hospitalizations, the Portuguese NHS incurred a direct economic burden of 1,831 million euros over the complete period, with total annual costs averaging 87,203,851 €, representing on average 0.93% of the NHS annual health expenditure. Conclusion: ACS represent a significant direct cost and economic burden for the NHS.
AB - Aim: We estimated the average direct cost per Acute Coronary Syndromes (ACS) in-patient episodes by diagnosis, namely ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA), and undetermined AMI (Acute Myocardial Infarction). We also analyzed the changes in direct costs over time between 2002 and 2022, and the total direct economic burden of ACS hospitalizations for the Portuguese National Health Service (NHS). Methods: We used the Portuguese Registry of Acute Coronary Syndromes (61,440 ACS hospitalizations), a cohort of people with ACS, recruited and followed from first hospitalization. A direct cost analysis was conducted. As resources, we considered health professional working hours, non-medical resources used during in-patient stays, laboratory and diagnostic tests, interventional cardiology procedures, pharmaceuticals, hospitalization-related complications, rehabilitation services, and death costs. A multivariate analysis was performed to identify the main cost determinants. Results: The average cost per ACS patient from 2002 to 2022 was 6,280.79 €. A significantly higher average cost was observed among patients diagnosed with STEMI of 3,853.26€ (95% confidence interval [CI] 3,690.87 to 4,015.65€), among NSTEMI patients of 1,308.91 € (95% CI 1,173.52 € to 1,444.30 €), and among patients who died during the hospitalization of 12,017.64€ (95% CI 11,232.21 € to 12,803.08 €). Over time, cost trends fluctuated, increasing until 2011 and then gradually decreasing until 2022, apart from 2020. Considering the total universe of 294,307 ACS-hospitalizations, the Portuguese NHS incurred a direct economic burden of 1,831 million euros over the complete period, with total annual costs averaging 87,203,851 €, representing on average 0.93% of the NHS annual health expenditure. Conclusion: ACS represent a significant direct cost and economic burden for the NHS.
KW - acute coronary syndrome
KW - acute myocadial infarction
KW - cost analysis
KW - economic burden of disease
KW - Portugal
UR - http://www.scopus.com/inward/record.url?scp=105001477772&partnerID=8YFLogxK
U2 - 10.3389/fpubh.2025.1433307
DO - 10.3389/fpubh.2025.1433307
M3 - Article
C2 - 40171428
AN - SCOPUS:105001477772
SN - 2296-2565
VL - 13
JO - Frontiers in public health
JF - Frontiers in public health
M1 - 1433307
ER -
