ABSTRACT
Background
Acute myocardial infarction (AMI) carries a substantial mortality and morbidity burden.
The purpose of this study is to provide annual mean cost per patient and national
level estimates of direct and indirect costs (lost productivity from morbidity and
premature mortality) associated with AMI.
Methods
Nationally representative data spanning 12 years (2003-2014) with a sample of 324,869
patients with AMI from the Medical Expenditure Panel Survey (MEPS) were analyzed.
A novel 2-part model was used to examine the excess direct cost associated with AMI,
controlling for covariates. To estimate lost productivity from morbidity, an adjusted
Generalized Linear Model was used for the differential in wage earnings between participants
with and without AMI. Lost productivity from premature mortality was estimated based
on published data.
Results
The total annual cost of AMI in 2016 dollars was estimated to be $84.9 billion, including
$29.8 billion in excess direct medical expenditures, $14.6 billion in lost productivity
from morbidity and $40.5 billion in lost productivity from premature mortality between
2003 and 2014. In the adjusted regression, the overall excess direct medical expenditure
of AMI was $7,076 (95% confidence interval [CI] $6,028-$8,125) higher than those without
AMI. After adjustment, annual wages for patients with AMI were $10,166 (95% CI −$12,985
to −$7,347) lower and annual missed work days were 5.9 days (95% CI 3.57-8.27) higher
than those without AMI.
Conclusions
The study finds that the economic burden of AMI is substantial, for which effective
prevention could result in significant health and productivity cost savings.
Key Indexing Terms
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Article info
Publication history
Published online: February 21, 2020
Accepted:
February 18,
2020
Received:
August 25,
2019
Footnotes
Disclosures: The authors declare that they have no competing interest.
Sources of funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
