Frequency and cost of the thirty long-term disorders in the Midi-Pyrénées region in 2003

Aims: To determine the frequency of the thirty long-term disorders (ALD 30 ) and to calculate the costs to the health fund according to the recorded diagnosis as a function of type of healthcare provided. Methods: We performed a descriptive survey of beneficiaries of the general scheme of the health fund in the Midi-Pyrénées region (1.7 million individuals in 2003). The frequency and cost of each of the ALD 30 was determined by consulting the health fund’s reimbursement database and the medical service’s database on benefits attributed to affiliates. Results: 210,130 patients had been attributed an ALD 30 in the Midi-Pyrénées region on December 31, 2003 (12.4 % of the covered population). Their average age was 62 years. 52 % of the patients were females. The most frequent affections recorded were malignant tumors (2.3 % of the affiliates in the general scheme), long-term psychiatric disorders (2.3 %) and diabetes mellitus (2.2 %). The average annual reimbursement per patient was 7,512 € , of which 4,942 € were directly related to their ALD 30 . The average annual reimbursement per patient varied from 3,000 to 30,000 € according to each different disease. 5 % of the patients who had been reimbursed for the greatest expenses represented 37 % of total expenditures. The average amount reimbursed to patients in their final year of life was 22,033 €. Conclusion: This type of analysis enables us to follow the financial resources that the health fund spends on patients who have been attributed an ALD 30 , both over time and geographically. The simultaneous increase in the frequency and the costs of the 30 long-term disorders represents an important augmentation in the healthfund’s expenditures.