Cardiovascular disease is the leading cause of death among Australians, accounting for 53,989 deaths or 42 % of all deaths in 1996. Diabetes mellitus is also a serious and growing health problem among Australians, affecting almost 4% of the population. Diabetes significantly increases the risk of cardiovascular disease and some of the health system costs of cardiovascular disease can be attributed to diabetes. This report provides a systematic analysis of total health system costs of cardiovascular diseases and diabetes in Australia in 1993–94.
Cardiovascular disease and its risk factors, including high blood cholesterol, cost the Australian community $3.9 billion in direct health system costs in 1993–94. This represents 12% of total recurrent health expenditure, making it the single most expensive disease group in terms of health system costs. The six cardiovascular conditions that accounted for the most of this $3.9 billion expenditure in 1993–94, in descending order, are:
- ischaemic heart disease–$894 million (23% of total cardiovascular disease costs)
- hypertension–$831 million (21%)
- cerebrovascular disease–$630 million (16%)
- heart failure–$411 million (10%)
- cardiac dysrhythmias–$224 million (6%)
- high blood cholesterol–$199 million (5%)
Health system costs for cardiovascular disease rise with age, reaching around $1,700 per capita per year on average for men and women aged 75 years and over.
The estimated average annual health system cost of hypertension is around $570 per diagnosed case, compared with around $210 per case of high blood cholesterol. The average treatment cost for a heart attack (acute myocardial infarction) is estimated to be around $5,060 for men and $4,760 for women in the age range 25–69 years.
The lifetime health system costs of stroke, for Australians who have at least one stroke, is estimated to be around $21,400 for men and $31,200 for women, or $25,800 on average for men and women combined.
The direct health system costs of diabetes mellitus are estimated to be $372 million in 1993–94, of which Type 1 (insulin dependent) diabetes accounts for an estimated $155 million and Type 2 (non-insulin dependent) diabetes for $217 million. When complications of diabetes are taken into account, the total health system costs of diabetes are estimated to be around $681 million in 1993–94. This corresponds to average annual expenditures of around $1,730 and $2,120 per diagnosed diabetic for males and females respectively.
The estimated lifetime costs of Type 1 diabetes are around $190,000 compared with $24,970 for Type 2. Estimated lifetime costs for females are 46% higher than those for males, reflecting higher annual treatment costs for females and higher life expectancies for females.