ORIGINAL ARTICLES   

International Angiology 1998 September;17(3):161-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Socio-economic impact of chronic venous insufficiency. An underestimated public health problem

Van Den Oever R., Hepp B., Debbaut B., Simon I.

From the National Alliance of Christian Health Insurance Funds, Medical Direction - Brussels, Belgium

Background. Disease of the ­venous ­system is an under­es­ti­mat­ed pub­lic ­health prob­lem affect­ing all West­ern indus­tri­al­ised coun­tries. The prev­a­lence of ­venous dis­ease of the lower limb in the adult pop­u­la­tion is esti­mat­ed at 40-50% for men and 50-55% for women, where­as vis­ible var­i­cose veins and chron­ic ­venous insuf­fi­cien­cy are, respec­tive­ly, ­present in 10-15% and 2-7% of the male pop­u­la­tion and 20-25% and 3-7% of the ­female pop­u­la­tion. In France the costs of ­venous dis­ease rep­re­sent­ed 2.6% of the total ­health care bud­get in 1995, thus con­firm­ing other data from European stud­ies and an early ­health sur­vey in the USA. To eval­u­ate the socio-eco­nom­ic ­impact of chron­ic ­venous insuf­fi­cien­cy by meas­ur­ing the ­health care cost.
Methods. Detailed infor­ma­tion on diag­nos­tic and ther­a­peu­tic pro­ce­dures for ­venous dis­ease was ­obtained from the bill­ing data of the com­pul­so­ry ­health insu­rance ­system in Belgium. Total ambu­la­to­ry and intra­mu­ral treat­ment costs are cal­cu­lat­ed for var­i­cose veins of the lower limb and for hae­mor­rhoids dur­ing the 1988-1995 peri­od.
Results. Medical care costs for chron­ic ­venous dis­ease ­amount to 10 bil­lion BEF, which is 2-2.5% of the 1995 total ­health care bud­get. Annual spend­ing on ven­o­trop­ic drugs with 11.5 mean daily doses per 1,000 inhab­i­tants amount­ed to one bil­lion BEF in 1995 for ambu­la­to­ry treat­ment only.
Conclusions. In view of the major med­i­cal, ­social and eco­nom­i­cal con­se­quenc­es of ­venous pathol­o­gy, ­research and pre­ven­tion ­efforts are ­required in this area as part of a well-tar­get­ed and effec­tive ­health pol­i­cy.