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Expenditures of the German statutory health insurance system for patients suffering from acute coronary syndrome and treated with percutaneous coronary intervention

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Abstract

Patients with acute coronary syndrome (ACS) are in need of cost-intensive treatment involving different aspects of the German Health System. Percutaneous coronary intervention (PCI) is the treatment of choice for a large proportion of cases. In the present study, an analysis of the cost impact of ACS with focus on PCI therapy was conducted across-the-board for the German Health System. Results indicated that 85% of all costs arising from treatment of ACS with a trial of PCI are due to in-patient care. Projection of results onto the entire insurant collective of the statutory health system estimated a total of €954,995,603—a proportional 0.7% of all expenditure by statutory health insurances in 2005.

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References

  1. Möllmann, H., Elsässer, A., Nef, H.M., et al.: Akutes Koronarsyndrom mit und ohne ST-Elevation. Herz 31, 820–826 (2006)

    Article  Google Scholar 

  2. Hamm, C.W.: Leitlinien: Akutes Koronarsyndrom (ACS) Teil 1: ACS ohne persistierende ST-Hebung. Z. Kardiol. 93, 72–90 (2004)

    Article  Google Scholar 

  3. Hamm, C.W.: Leitlinien: Akutes Koronarsyndrom (ACS) Teil 2: Akutes Koronarsyndrom mit ST-Hebung. Z. Kardiol. 93, 324–341 (2004)

    Article  Google Scholar 

  4. German Census Bureau: Ergebnisse der Todesursachenstatistik für Deutschland ausführliche vierstellige ICD10-Klassifikation. Wiesbaden (2007)

  5. Silber, S., Albertsson, A., Avilés, F.F.: Guidelines for percutaneous coronary interventions. Eur. Heart J. 26, 804–847 (2005)

    Article  Google Scholar 

  6. Bassand, J.P., Hamm, C.W., Ardissino, D., et al.: Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur. Heart J. 28, 1598–1660 (2007)

    Article  Google Scholar 

  7. Murray, C.J.L., Lopez, Z.D.: Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 349(9064), 1498–1504 (1997)

    Article  Google Scholar 

  8. Van de Werf, F., Bax, J., Betriu, A., et al.: Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. Eur. Heart J. 29, 2909–2945 (2008)

    Article  Google Scholar 

  9. Zhang, Z., Spertus, J.A., Mahoney, E.M., et al.: The impact of acute coronary syndrome on clinical, economic, and cardiac-specific health status after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: 1-year results from the stent or surgery (SoS) trial. Am. Heart J. 150(1), 175–181 (2005)

    Article  Google Scholar 

  10. Taylor, M., Scuffham, P.A., McCollam, P.L., Newby, D.E.: Acute coronary syndromes in Europe: 1-year costs and outcomes. Curr. Med. Res. Opin. 23(3), 495–503 (2007)

    Article  Google Scholar 

  11. Etemad, L.R., McCollam, P.L.: Total first-year costs of acute coronary syndrome in a managed care setting. J. Manag. Care Pharm. 11(4), 300–306 (2005)

    Google Scholar 

  12. Giersiepen, M.P.H., Pohlabeln. H., Egidi, G., Pigeot I.: Die ICD-Kodierqualität für Diagnosen in der ambulanten Versorgung. Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz. 50, 1028–1038 (2007)

  13. German Institute for Medical Documentation (DIMDI): ICD-10-GM. Videel, Cologne (2003)

  14. German Institute for Medical Documentation (DIMDI): Operationen- und Prozedurenschlüssel, Internationale Prozeduren in der Medizin. http://www.dimdi.de/static/de/klassi/prozeduren/ops301/opshtml2007/fr-ops.htm (2005). Accessed 16 Jan 2008

  15. Federal Association of panel doctors (KBV): Einheitlicher Bewertungsmaßstab. Deutscher Ärzte-Verlag, Cologne (2001)

  16. Filler, G., Hermanns, P.M.: EBM2000plus. Ebner & Spiegel, Munich (2005)

  17. Tschöpe, D., Stratmann, B., Standl, E., et al.: Diagnostik und Therapie von Herzerkrankungen bei Diabetes mellitus. In: Scherbaum W.A., Kerner W. (eds.) Evidenzbasierte Leitlinie der Deutschen Diabetes-Gesellschaft (DDG). http://www.deutsche-diabetes-gesellschaft.de/leitlinien/EBL_Herz_Update_2006.pdf (2006). Accessed 10 June 2008

  18. Wittchen, H.-U., Glaesmer, H., März, W., et al.: Cardiovascular risk factors in primary care: methods and baseline prevalence rates—the DETECT program. Curr. Med. Res. Opin. 21(4), 619–629 (2005)

    Article  Google Scholar 

  19. Federal Department of Health: KM6 Statistic 2005. http://www.bmg.bund.de/cln_110/nn_1168258/sid_1D7F6357FF36FEF0FCA44109C1213CE6/SharedDocs/Downloads/DE/Statistiken/GesetzlicheKrankenversicherung/Mitglieder-und-Versicherte/2005-km6-lang-pdf.html (2006). Accessed 15 Jan 2008

  20. BKK Bundesverband: Gesundheitsreport 2006, Demografischer und wirtschaftlicher Wandel—gesundheitliche Folgen. Essen (2006)

  21. Fricke, G., Günther, J., Zawinell, A.: ATC-Index mit DDD-Angaben für den deutschen Arzneimittelmarkt. WIdO, Bonn (2007)

  22. Dijksman, L.M., Hirsch, A., Winhausen, F., Asselman, F.F.: Cost effectiveness of early versus selectively invasive strategy in patients with acute coronary syndromes without ST-segment elevation. Int. J. Cardiol. 131(2), 204–211 (2009)

    Article  Google Scholar 

  23. Epstein, D.M., Sculpher, M.J., Clayton, T.C., et al.: Costs of an early intervention versus a conservative strategy in acute coronary syndrome. Int. J. Cardiol. 127(2), 240–246 (2008)

    Article  Google Scholar 

  24. Bramkamp, M., Radovanovic, D., Erne, P., Szucs, T.D.: Determinants of costs and the length of stay in acute coronary syndromes: a real life analysis of more than 10 000 patients. Cardiovasc. Drugs Ther. 21, 389–398 (2007)

    Article  Google Scholar 

  25. Fricke, F.U., Silber, S.: Können Medikamente frei setzende Koronarstents eine Bypassoperation ersetzen? Herz 30(4), 332–338 (2005)

    Article  Google Scholar 

  26. Bundesärztekammer (BÄK), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Kassenärztliche Bundesvereinigung (KBV). Nationales Programm für Versorgungs-Leitlinien. Nationale Versorgungs-Leitlinie Chronische KHK. Kurzfassung, Version 1.8. http://www.khk.versorgungsleitlinien.de (2008). Accessed 25 June 2009

  27. Federal Department of Health: Endgültige Rechnungsergebnisse der GKV 2005. http://www.bmg.bund.de/cln_110/nn_1193098/SharedDocs/Downloads/DE/Statistiken/GesetzlicheKrankenversicherung/finanzergebnisse/KJ12005,templateId=raw,property=publicationfile.pdf/KJ12005.pdf (2006). Accessed 1 Nov 2008

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Acknowledgments

This study was supported by Lilly Deutschland GmbH and Daiichi Sankyo Co Ltd. Cooperation with company health insurance funds (BKK) made it possible to analyse health care data of insured persons.

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Correspondence to Heiko Friedel.

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Friedel, H., Delges, A., Clouth, J. et al. Expenditures of the German statutory health insurance system for patients suffering from acute coronary syndrome and treated with percutaneous coronary intervention. Eur J Health Econ 11, 449–455 (2010). https://doi.org/10.1007/s10198-009-0181-2

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  • DOI: https://doi.org/10.1007/s10198-009-0181-2

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