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DIRECT EXPENDITURES BY DISEASE

Statistics Directorate    
Definition:
Direct expenditure by disease relates to the economic burden incurred by the health system to diagnose and treat health problems classified according to the International Classification of Diseases 9 (ICD-9).

Context:
Results reflect the amount of expenditures incurred during a period of time equivalent to the prevalence of the disease over the same period, typically one year. The incidence, or on-set, of disease is not considered. Moreover, the indirect economic burden associated with lost productivity due to morbidity or premature mortality is not considered. Data on direct expenditure by disease can be further disaggregated according to type of service provided: inpatient, outpatient, and pharmaceutical.

Typically, data on direct expenditures by disease are derived from national cost-of-illness studies, which identify and measure the costs of a particular disease category. As estimation standards tend to vary across countries, considerable care must be applied in interpreting cross-national results.

First, the classification of symptoms sometimes varies across countries. For example, in the UK, outpatient and pharmaceutical expenditures associated with Diseases of the Nervous System (ICD-9 category VI) are included instead under Mental Disorders (ICD-9 category V).

Second, methodological approaches differ in the ways that cost-of-illness studies are conducted. In the US and Australia inpatient expenditure by disease is estimated by apportioning total inpatient spending according to resource use for each disease (using data on disease-related groups).

However, in The Netherlands and Germany, inpatient expenditure is estimated using data on average length of stay and the assumption that the cost per day for all diseases is the same. Finally, some types of medical expenditures are excluded altogether from estimates. For example, Japan does not include expenditures on over-the-counter drugs in its estimates.

Source Publication:
OECD Health Data 2001: A Comparative Analysis of 30 Countries, OECD, Paris, 2001, data sources, definitions and methods
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Statistical Theme: Health statistics

Created on Tuesday, September 25, 2001

Last updated on Friday, March 15, 2002