THE INTRODUCTION OF ECONOMIC CRITERIA INTO THE MANAGEMENT OF ARTERIAL-DISEASE - AN ILLUSTRATION WITH REGARD TO THE SOCIOECONOMIC CONSEQUENCES OF PERIPHERAL OCCLUSIVE ARTERIAL-DISEASE OF THE LOWER-LIMBS

A survey of studies was used to investigate the economic repercussions of arterial disease; these repercussions included the cost of the dis ease and its management, and cost/efficacy, cost/utility, and cost/ben efit studies of preventive, diagnostic, and therapeutic strategies. Th e study presented is an evaluation of the socioeconomic consequences o f peripheral occlusive arterial disease of the lower limbs (POADLL). T he cost of health care was measured by means of a prospective 6-month study of 85 patients recruited in 6 centers. The average cost over the 6-month period was 15,735 FF (1991 francs) ($2,760 U.S.). The 85 pati ents were classified by age, sex, risk factors, concomitant disease, a nd how the illness was managed, notably in terms of hospitalization an d vascular surgery. The four-group classification was used to calculat e an annual management cost for POADLL, which ranged from 9,500 FF ($1 ,667 U.S.) for a stage II patient (mean age, 66 years) with no major r isk factors and not presenting any complication requiring admission to hospital, to 35,000 FF ($6,140 U.S.) for patients (mean age, 62 years ) who presented major risk factors and who required vascular surgery d uring the year.