A new study in this months's Journal of Occupational and Environmental Medicine gets right to the heart of the health care cost problem for employers: workers with cardiac problems are a major source of direct and indirect health care costs.

"Acute coronary syndrome is more costly to employers and payers than other health conditions that are common among employed persons," according to the new research, led by Stephen S. Johnston, M.A., of Thomson Reuters, Washington, DC.

Based on an analysis of medical insurance claims, the researchers estimated the costs of ACS for employers and health care payers. “Acute coronary syndrome” refers to a range of heart conditions, including different types of myocardial infarction as well as unstable angina. Nearly half of all ACS patients are of working age, previous studies have found.

The results confirmed the high direct costs (that is, costs for medical care) for workers with ACS — $40,000 higher, on average, than for other workers. The initial hospitalization accounted for about one-half of these costs. Thirty percent of workers with ACS had at least one more heart disease hospitalization within the next year.

Acute coronary syndromes were also associated with higher indirect costs for short-term disability: about $1,000 per year. Costs due to absence from work were not significantly increased, but this was based on a small number of cases.

The findings show that ACS is even more costly than other conditions common in working-age adults, such as asthma, high blood pressure, and diabetes. "Patients with ACS represent a substantial direct and indirect cost burden for employers and payers and incur productivity losses that may greatly affect employers," the researchers conclude. They believe that their data on comparative costs will be useful in prioritizing resources for the treatment and prevention of ACS.

The Journal is the official publication of the American College of Occupational and Environmental Medicine (ACOEM).