The portion of the U.S. population with heart disease will grow larger and live longer with the condition during the coming decades, driving up healthcare spending, according to a Health Affairs study.
However, hospitals can help contain costs by delivering more efficient and cost-effective care, among other reforms, says Ankur Pandya, PhD, an assistant professor of public health at
The study predicts the average 10-year risk of heart disease will rise to 15.1 percent for men and 8.6 for women by 2030, compared with 12.7 percent and 6.8 percent, respectively, in 1991. The number of people who put themselves at risk by smoking is on the decline, and treatment continues to improve and drive down mortality rates. However, those factors won't outweigh the influence of the obesity epidemic and the aging baby boomer population, according to the study.
As the prevalence of heart disease and the life expectancy of those who have it go up, healthcare costs will also increase, Dr. Pandya says.
Coronary heart disease alone costs the U.S. $108.9 billion annually, including the cost of healthcare services, medications and lost productivity, according to the Centers for Disease Control and Prevention. Dr. Pandya says heart disease is the costliest disease category, and hospital spending accounts for about half of the cost of treating it.
"Our model from the study forecasts that we're going to see an increase in the number of acute cardiovascular events," he says. "This would imply that if hospitals could improve the efficiency in how they handle cardiovascular disease, it could have a real impact."
Reducing hospital readmissions, optimizing workflow in the acute-care setting and the implementation of cost-effective practices could all reduce the prevalence of heart disease and subsequently help contain costs, he says.
Hospitals should continue to identify high-value practices by asking themselves if the most costly services they deliver are worth the money in terms of health outcomes, he says. Incentivizing cost-effectiveness and discouraging unnecessary imaging, lab tests and other potentially unneeded procedures could go a long way to stop healthcare spending from ballooning along with the incidence of heart disease.
For providers looking for guidance on reducing unnecessary care, the Advancing Medical Professional to Improve Health Care Foundation's Choosing Wisely initiative has compiled lists of five things physicians and patients should question to eliminate unneeded care from specialty societies representing more than 500,000 physicians.
The study also concludes policies that aim to fight high blood pressure and cholesterol as well as obesity would help stop skyrocketing rates of the condition.
However, the advancing age of the baby boomers will still inevitably make the condition a bigger issue, Dr. Pandya says. The aging population is a significant factor driving the increase in spending on major healthcare programs overall, according to the Congressional Budget Office. Between now and 2038, the portion of the population aged 65 and older is expected to increase from 14 percent to 21 percent. Furthermore, the percentage of the population 80 and older will grow from 4 percent to 7 percent.
"You can only plan for the surge in prevalence and become as efficient as possible to keep cardiovascular disease spending under control," Dr. Pandya says.
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