Economic impact of cardiovascular disease on the South African economy, 1991

Summary in English.nord processed copy.Includes bibliographies and index.Cardiovascular disease (CVD) is a generic medical term which is applied to any malfunctioning of the circulation of blood in the body. lschaemic heart disease, cerebrovascular disease, cardiac failure and aneurysm are among the specific diseases subsumed under this term. These diseases are diseases of lifestyle, and have a severe impact on first world economies. CVD is the leading cause of death among the White, Asian and Coloured population in South Africa, and ranks third for Blacks. South Africa is currently experiencing a rapid rate of urbanisation and redistribution of income (and wealth). The rural-urban-transition is accompanied by the adoption of western lifestyles. Consequently, the incidence of CVD is expected to increase markedly. Tightening fiscal constraints have led to serious focus on allocative efficiency in the health care sector. Cost effectiveness requires that all disease categories be examined. A costing study is usually the first step in this procedure. This thesis estimates the cost of CVD to the South African economy in 1991. Health economics is in its infancy in South Africa and no cost-of-illness study has been carried out in this country before. This study is thus a pioneering work in many ways; an appropriate methodological framework in which to conduct the costing had to be developed. Types of costing in health economics, the South African health sector, the aetiology of CVD and the value of a human life are reviewed. An exposition of the major methodologies of calculating direct and indirect costs of disease is given, and the advantages and disadvantages of each are discussed. A direct and indirect cost-of-illness method for the purpose of the project is chosen, and arguments are advanced for their suitability in any cost-of-illness study in the South African context