The Economic Burden of Cardiovascular Diseases in Yemen

An example of annual direct costs from the Cardiac Center–Althawra Teaching General Hospital- Sana’a

Abstract

Background and Objectives: Cardiovascular diseases is a progressing major health problem . The
impact of this problem is pronounced in developing
countries . Yemen is one of the developing countries and one of the low income country group .
Being the only public comprehensive cardiac facility in the country ; The cardiac center of Althawra Teaching General Hospital is one of the busiest
health facility in Yemen . The cardiovascular diseases ( CVD) causes major medical and social
consequences and impose a heavy economic burden on Yemen . The major aim of this study is to
estimate the annual cost of direct cardiac services
in this center. The economic visibility of establishing cardiac specialty centers in Yemen ; Hence the
effect of that on prevention and control as management of CVD.
Materials and methods: This research is retrograde data collected ; the number and costs of the
cardiac services provided by the cardiac center to
the patients were calculated and evaluated for all
the cardiac services including : the visitors to the
cardiac out patients clinics ( cardiology and cardiac surgery ) , admissions , non invasive modalities ,
invasive procedures , cardiac surgery in adults and
pediatrics and pacemakers implantations . All the
direct costs were estimated according to average
basic costs from four private hospitals in Yemen
. Excluded from this calculations the running costs
, special subsidiaries and invisible costs during the
year 2011 . All data were subjected for statistical
evolution using SPSS v. 16 program. The resulted
correlations were projected to represent the direct
cost of cardiac service per average patient in one
year period .
Results: Apart from the country political situation
; during the study period the rate of bed occupancy was high all over the cardiac center , the total
capacity of beds were 107 beds out of it 27 were
used in CCU ( post surgical and medical ) , rate of
bed rotation was 69.42 cycle and average patient
stay was 5.2 (±3.5) days the basic estimated total
cost of hospitalization 1.872.450 US Dollar . The
non-invasive procedures for both in patient and
out patients services ; which include : Echocardiography & Doppler examination , Transesophageal
Echocardiography ( TEE ) , Stress ECG , ECG ,
Holter ECG and 24 hour BP recording , with a total
basic average cost of 285.000 US Dollar. Diagnostic coronary angiography was performed in 2053
patients with estimated basic cost of 1.026.000 US
Dollar . Adults Catheterization Cardiac interventions include coronary and valvular interventions
was 2.785.400 US Dollar. The pediatric diagnostic and interventions with estimated basic cost of
297.000 US Dollar. Patients with permanent cardiac pacing with a cost of 600.600 US Dollar. While
the main bulk was for cardiac surgery the estimated
basic cost was 4.656.750 US Dollar. The estimated cost out patient visit was minimal 1920 US
Dollar due to low fees for consultation .The annual
direct cost for cardiac services in the cardiac center is 11.525. 120 US Dollar . Excluded from this
calculations the running costs , special subsidiaries
and invisible costs. Keeping in mind that the cost of
establishment of the cardiac center is 5 million US
Dollar inclusive the building and equipments .
Conclusions and recommendations: One year on
average daily activity, Althawra Teaching General
Hospital - Cardiac Center has achieved approximately two and halve times the basic establishment cost of the center . The magnitude of CVD
problem is high that is mandate the health authority
to provide effective prevention and control programs . The cost/benefit equation cannot yet be
solved in purely financial terms but from the above,
the socio-economic advantages of a local Cardiac
Centre should be clear. Establishing governmental
and private cardiac center is essential to decrease
the health expenses of travelling abroad for cardiac
services.