Cureus. 2026 Apr 28;18(4):e107924. doi: 10.7759/cureus.107924. eCollection 2026 Apr.
ABSTRACT
Background Coronary atherosclerosis remains a leading cause of ischemic heart disease and cardiovascular morbidity and mortality. While its clinical burden is well described, less is known about how its economic burden, defined using absolute expenditures and relative measures such as share of economic output, has changed over time. Objective To evaluate national trends in expenditures and utilization for coronary atherosclerosis and assess changes in its economic burden relative to the overall United States (US) economic output and healthcare sector growth. Methods National expenditure data from 2000 to 2021 were obtained from the National Income and Product Accounts (NIPA). Disease-specific spending was benchmarked against the total US gross output, used as a proxy for overall economic activity rather than direct gross domestic product (GDP) estimates, and the Healthcare and Social Assistance sector output. Outcomes included per capita spending, episode volume defined as aggregated counts of condition-specific healthcare encounters, total expenditures based on constant-dollar inflation-adjusted NIPA estimates, uncontrolled expenditures defined as non-population-adjusted totals, and cost per case. Temporal trends were evaluated using univariate linear regression. Results Between 2000 and 2021, per capita spending declined from $90.70 to $64.54 (-28.8%), with an average annual decrease of $1.86 (p<0.0001). Episode volume decreased from $13.34 million to $11.22 million (-15.9%), corresponding to an annual reduction of 136,874 episodes (p<0.0001). Total expenditures declined from $255.9 billion to $213.6 billion (-16.6%), with an annual decrease of $381.6 million (p=0.0003). Uncontrolled expenditures declined from $196.9 billion to $173.7 billion (-11.8%) (p=0.0004). Cost per case changed minimally, decreasing from $1,918 to $1,904 (less than 1% decline; p=0.026). Spending as a share of the total US economic output declined from 0.17% to 0.06% (p<0.001). Conclusion In this national, longitudinal analysis, the economic burden of coronary atherosclerosis declined across multiple absolute measures and relative benchmarks. These findings reflect reductions in spending and utilization over time; however, given the observational and aggregate nature of the data, underlying drivers cannot be determined. Macroeconomic benchmarking of disease-specific expenditures may provide a useful framework for evaluating long-term trends in healthcare spending.
PMID:42220717 | PMC:PMC13220657 | DOI:10.7759/cureus.107924