Treated and untreated hypertension, hospitalization, and medical expenditure: an epidemiological study in 314 622 beneficiaries of the medical insurance system in Japan
Treated and untreated hypertension, hospitalization, and medical expenditure: an epidemiological study in 314 622 beneficiaries of the medical insurance system in Japan
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DOI：
10.1097/hjh.0b013e32835f5747
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发表时间：
2013-05-01
影响因子：
4.9
通讯作者：
Okayama, Akira
中科院分区：
文献类型：
--
作者：
Nakamura, Koshi;Miura, Katsuyuki;Okayama, Akira
目的：研究高血压对日本人群住院风险和医疗费用的影响。方法：日本医疗保险系统的314622名受益人，年龄40-69岁，无心脑血管病史或终末期肾脏疾病，被分为7个血压类别。这些分类用于比较基线调查后1年内住院的风险，并检查研究人群中因高血压引起的住院医疗费用相对于总医疗费用的百分比。结果：随访期间，6.6%的男性和5.1%的女性住院治疗。在40-54岁的男性和女性中，与最佳血压相比，高血压病例，特别是3级未经治疗的高血压，导致更频繁的住院治疗。无论其高血压状况如何，住院治疗的个体，特别是长期住院治疗的个体，与未住院治疗的个体相比，其医疗支出要高得多。在55-69岁的女性中，不同血压类别的住院风险几乎没有变化。40-54岁男性和55-69岁男性因高血压引起的住院医疗支出分别占总医疗支出的7.2%和6.9%，而女性则分别占2.8%和3.8%。结论：虽然高血压病例是一种经济负担，特别是在男性中，但与其他病例相比，3级高血压未经治疗更有可能因住院而产生极高的医疗费用。
Objective: This study investigated the effect of hypertension on hospitalization risk and medical expenditure according to treatment status in a Japanese population.Methods: A total of 314 622 beneficiaries of the medical insurance system in Japan, aged 40-69 years, without a history of cardiovascular, cerebrovascular, or end-stage renal disease were classified into seven blood pressure categories. These categories were used to compare the risk of undergoing hospitalization in the 1 year after the baseline survey and to examine the percentage of inpatient medical expenditure attributable to overall hypertension relative to total medical expenditure in the study population.Results: During the follow-up period, 6.6% of men and 5.1% of women were hospitalized. In men and women aged 40-54 years, cases of hypertension, especially grade 3 untreated hypertension, led to more frequent hospitalization, compared with optimal blood pressure. Individuals who were hospitalized, especially long-term, incurred considerably higher medical expenditure compared with those who were not hospitalized, regardless of their hypertension status. In women aged 55-69 years, there was little variation in hospitalization risk across blood pressure categories. The inpatient medical expenditure attributable to overall hypertension represented 7.2 and 6.9% of the total medical expenditure for men aged 40-54 and 55-69 years, whereas it represented 2.8 and 3.8% for women, respectively.Conclusion: Although cases of hypertension were an economic burden especially in men, grade 3 untreated hypertension was more likely to incur extremely high medical expenditure as a result of hospitalization, compared with other cases.