Objectives Currently, 80% of all CVD deaths worldwide occur in developing countries. China, with the largest population in the world, has experienced increasing economic burden of CVD. A systematic review was conducted to assess economic burden and hospital costs associated with stroke, myocardial infarction (MI) and revascularisation procedures.
Methods A literature review of studies published during 2002 – 2012 with a focus on the direct costs of stroke, MI and revascularisation procedures was completed using MEDLINE and EMBASE. Hospital costs were extracted from the studies and summarised. Data describing societal costs of CVD events overall also were extracted and summarised.
Results Thirteen studies were identified for data extraction. The majority of the studies were retrospective by design. Ten studies were conducted in urban settings; one study in a rural setting and only two studies collected data from both urban and rural settings across the country. Eight studies provided data on direct costs of stroke, two provided data on direct costs of MI, and three provided data on direct costs on revascularisation procedures. The average of a hospital cost for stroke patients ranged from approximately 1700 Yuan to 16500 Yuan. The hospital costs available for MI patients ranged from approximately 9000 Yuan to 34000 Yuan. The least documented outcome was costs for revascularisation procedures. Only one study was available for CABG and PCI each (75,000 and 54,750 Yuan, respectively). Few national estimates of economic burden of CVD events were available for extraction. One study estimated that direct medical costs of inpatient and outpatient services for cerebrovascular diseases in 2003 totaled $37.5 billion Yuan. One other study showed that the country’s GDP lost due to total CVD events was estimated to top $1 billion in 2006
Conclusions The economic burden of CVD in China is huge and increasing over time. The direct costs available for stroke and MI patients vary substantially due to potentially the differences in how costs were defined and to the differences in the geographic settings of respective studies. Few national estimates were available; additional national-level studies in China are needed to quantify the economic burden of CVD.