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- Burden of disease and cost of illness of atrial fibrillation in PortugalPublication . Gouveia, Miguel; Costa, João; Alarcão, Joana; Augusto, Margarida; Caldeira, Daniel; Pinheiro, Luís; Carneiro, António Vaz; Borges, MargaridaIntroduction and Objectives: Atrial fibrillation is the most prevalent sustained arrhythmia. This paper estimates the burden and cost of illness attributable to atrial fibrillation in Portugal based on demographic and health statistics. Methods: Mortality data by cause of death came from the European Detailed Mortality Database of the World Health Organization (WHO). Hospital data were taken from the Portuguese diagnosis-related groups database. The burden of disease was measured using DALYs (disability-adjusted life years), a metric adopted by the WHO. Costs studied included resource use and lost productivity. The burden and cost of illness are those attributable to atrial fibrillation and its main complication, ischemic stroke. Results: In Portugal, 4070 deaths were attributable to atrial fibrillation in 2010, corresponding to 3.8% of all deaths. In total, the burden of disease attributable to atrial fibrillation was estimated at 23 084 DALYs: 10 521 resulting from premature deaths (1.7% of the total DALYs due to death in 2010 in Portugal), and 12 563 resulting from disability. The total estimated direct costs attributable to atrial fibrillation at 2013 prices were 115 MD (million euros): 34 MD for inpatient care and 81 MD for outpatient care. Indirect costs resulting from lost production due to disability were estimated at 25 MD. Conclusions: Atrial fibrillation has an important social impact in Portugal due to its associated mortality and morbidity, and was responsible in 2013 for a total cost of 140 MD , about 0.08% of gross domestic product.
- Carga da doença atribuível ao tabagismo em PortugalPublication . Borges, Margarida; Gouveia, Miguel; Costa, João; Pinheiro, Luís dos Santos; Paulo, Sérgio; Carneiro, António VazThe World Health Organization's (WHO) 2002 Annual Report estimated that about 14% of the burden of disease in wealthier countries is attributable to smoking. Smoking related diseases include cardiovascular diseases, cancer and respiratory diseases. This paper presents an estimate of the burden of disease attributable to smoking in Portugal. The estimates are based on the Portuguese demographic and health statistics available for 2005. The most important conclusion of the analysis is that 11.7% of deaths in Portugal are attributable to smoking. If we use disability adjusted life years (DALYs) to measure the burden of disease, we find that 11.2% of death DALYs in Portugal is attributable to smoking. The gender distribution of this amount is very unequal; 15.4% of the male burden of disease and 17.7% of all male deaths can be attributed to smoking, but only 4.9% of the female burden of disease and 5.2% of all female deaths. These estimates are higher than death estimates previously available (Peto et al. 2006); 14% in men and only 0.9% in women. This paper also presents estimates of the burden of reducible disease, that is, the reduction in mortality and DALYs that would occur if all current smokers quit and thus experienced the mean risk of ex-smokers, which is lower than for current smokers but typically not as low as for never-smokers. Our estimates are that the burden of disease would decrease by 5.8% (7.8% in men and 2.8% in women), and that deaths would decrease by 5.8% as well (with an 8.5% and 2.9% decrease in men and women, respectively). The paper also includes estimates of the burden of disease generated by smoking related disability. Smoking related illnesses generated 121,643 DALYs, 72,126 (59%) of which are attributable to smoking and 12,417 would be reducible if all smokers were to quit.
- Custos da doença atribuíveis à hipercolesterolémia em PortugalPublication . Gouveia, Miguel; Borges, Margarida; Costa, João; Oliveira, Eduardo Infante de; David, Cláudio; Carneiro, António VazCardiovascular diseases are the main cause of death in Portugal, in developed countries and, indeed, worldwide. Hypercholesterolemia is a major risk factor for these diseases, including ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. This paper reports the results of a study of the cost of illness associated with hypercholesterolemia and the costs directly attributable to hypercholesterolemia in Portugal, estimated from data for the year 2000. The results indicate that the cost of the health care provided to deal with illnesses associated with hypercholesterolemia was Euros 735.9 million (direct costs) and the costs of lost production due to disability of patients of working age was Euros 74.82 million (indirect costs). The costs attributable to hypercholesterolemia, those that would be avoided if hypercholesterolemia were completely eliminated, amount to Euros 358.84 million in direct costs and Euros 28.31 million in indirect costs. These results confirm that hypercholesterolemia is a source of major health costs. This means that hypercholesterolemia deserves special attention from those who formulate health policy and should be given priority in implementing such policies.
- Carga da doença atribuível à hipercolesterolémia em PortugalPublication . Gouveia, Miguel; Borges, Margarida; Costa, João; Carneiro, António VazCardiovascular diseases are the main cause of death in Portugal, in developed countries and indeed, worldwide. Hypercholesterolemia is a major risk factor for these diseases. What are the potential health gains to be obtained by reducing the prevalence of hypercholesterolemia in the Portuguese population? How are they to be estimated and quantified? Studies of the burden of disease aim to measure and evaluate the impact of a disease or group of diseases on overall levels of health. Although they do not strictly speaking constitute an economic evaluation, since no specific interventions are analyzed, burden of disease studies do provide an accurate picture of a specific health problem and its magnitude, as well as an indication of changes in health policy and in preventive or corrective measures that might lead to improvement. This paper reports the results of a study of the disease burden of hypercholesterolemia in Portugal, calibrated for data from the year 2000. In this study, the disease burden is estimated as the component attributable to hypercholesterolemia in DALYs (disability-adjusted life years). DALYs are a measure used by international organizations such as the World Health Organization and the World Bank.