MEASUREMENT OF HEALTH OUTCOME AND ASSOCIATED COSTS IN CARDIOVASCULAR-DISEASE

As a result of scarcity of resources, combined with increased demand a nd the introduction of newer, more expensive technologies, choices hav e to be made about the allocation of funds between competing therapeut ic options and priorities. Economic evaluation provides a means of mak ing such choices more rational and the allocation of resources more ef ficient. Essentially, there are four types of health-economic evaluati on: cost-minimization, cost-effectiveness, cost-utility and cost-benef it analysis. Costs associated with cardiovascular care amount to 12-13 % of the Swedish healthcare budget. Most of the direct costs associate d with treating cardiovascular disease are spent on inpatient care. Th e indirect costs associated with morbidity and mortality are much grea ter than direct costs. The treatment of hypertension provides a good e xample of how direct costs of therapy must be balanced against long-te rm benefits. Long-term costs of uncontrolled hypertension include thos e resulting from other cardiovascular diseases for which hypertension is a significant risk factor, involving the brain, kidneys and arteria l system. Benefits from anti-hypertensive therapy are greater in older patients and in those with more severe blood pressure elevation. In t hose over 70 years old with a diastolic blood pressure between 100 and 104 mmHg, effective anti-hypertensive therapy has actually been demon strated to result in a cost saving.