VENOUS DISEASE, AN ILL-RECOGNIZED PUBLIC- HEALTH PROBLEM IN FRANCE

Different reasons explain that chronic venous insufficiency remains il lrecognized as a public health problem in France : very few epidemiolo gic studies have been undertaken in this pathology ; this disease is v ery heterogeneous in terms of gravity and clinical evidence : from iso lated symptoms to localized clinical signs, with or without severe com plications. Clinical semiology is actually not standardised. The analy sis of available informations suggests that this pathology represents approximately 2,6 % of the whole health expenditures in France, that i s to say an amount of 14,7 billion of Francs for the year 1991. The nu mber of patients suffering from chronic venous insufficiency can be es timated to about 11 millions, whose 7 millions present symptomatic sig ns (leg heaviness, pain, moderate edema). The number of hospitalizatio ns is around 200 000 per year, of which 63 % are in surgery in private clinics. One half of this hospital stays concerne varicose veins (the 8th cause of hospitalization in France). Forty of the patients consul ting for chronic venous insufficiency are at work and about 7 to 8 % o f them get sick leaves for this pathology : around 362 000 sick leaves per year representing 6,4 millions of day lost. On the basis of the m edical consumption survey performed by INSEE/CREDES, an extrapolation was made to estimate the different components of costs of chronic veno us insufficiency : 41 % (drugs), 34 % (hospital care) and 13 % (medica l fees) (J Mal Vasc 1994 ; 19 : pages 185-189).