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