Inequality-related economic burden of communicable diseases in Canada.

Background Communicable diseases cause a significant burden on society in terms of health care expenditures and their health impact on individuals. Cost-of-illness studies estimate the total economic burden of illness and injury. Objective To identify the economic burden of illness for communicable diseases in Canada, and to derive the costs associated with inequalities based on income and hospital expenditures. Methods Data were derived from the Economic Burden of Illness in Canada (EBIC) database, for the year 2008. Data for communicable diseases were extracted and compared to the overall results. Data on income level was available for hospital expenditures, and was analyzed by income quintile. Results The total costs attributable to communicable diseases in Canada were $8.3 billion, which represented 9% of the total costs that could be attributed to a specific disease or diagnostic category. Indirect costs accounted for 44% of total communicable disease costs and represented a more significant proportion of the economic burden related to communicable diseases compared to non-communicable diseases. When hospital costs by income quintile were analyzed, a clear inverse relationship was found between income and hospital expenditures. The costs associated with this inequality in 2008 were $308 million. The current estimates are likely to be an underestimate due to the conservative assumptions made in the analysis. Conclusion The cost of communicable disease in Canada is sizable and there is a clear correlation between lower income and higher hospital costs. Further research is needed to better account for co-morbid conditions and to better estimate the value of lost productivity related to disability arising from communicable diseases.