Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003-2014.
Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003-2014.
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DOI：
10.1161/jaha.118.008731
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发表时间：
2018-05-30
影响因子：
5.4
通讯作者：
Moran WP
中科院分区：
文献类型：
--
作者：
Kirkland EB;Heincelman M;Bishu KG;Schumann SO;Schreiner A;Axon RN;Mauldin PD;Moran WP
三分之一的美国成年人患有高血压或高血压。由于先前的预测表明高血压是所有心血管疾病中费用最高的，因此确定与高血压相关的医疗保健支出的现状非常重要。我们使用了一个具有全国代表性的数据库，即医疗支出小组调查，来计算高血压患者的估计年度医疗支出，并纵向测量12年期间的支出趋势。使用两部分模型估计高血压患者与非高血压患者的调整后增量支出。纳入性别、种族/民族、教育、保险状况、人口普查地区、收入、婚姻状况、Charlson Comorbid指数和年份类别作为协变量。2003-2014年的汇总数据包括224920名成年人的总样本，其中36.9%患有高血压。高血压患者未调整的平均年医疗费用为9089美元。相对于没有高血压的人，高血压患者每年调整后的增量支出高出1920美元，是住院费用的2.5倍，几乎是门诊费用的两倍，处方药支出几乎是处方药支出的三倍。根据美国高血压的患病率，估计高血压成人人群与非高血压人群相比，调整后的年增量成本高出1310亿美元。据估计，高血压患者每年的医疗费用比非高血压患者高出近2000美元。12年来，这一趋势相对稳定。与高血压相关的医疗费用约为1310亿美元。这就需要对高血压的预防和管理做出巨大努力。
One in 3 US adults has high blood pressure, or hypertension. As prior projections suggest hypertension is the costliest of all cardiovascular diseases, it is important to define the current state of healthcare expenditures related to hypertension. We used a nationally representative database, the Medical Expenditure Panel Survey, to calculate the estimated annual healthcare expenditure for patients with hypertension and to measure trends in expenditure longitudinally over a 12‐year period. A 2‐part model was used to estimate adjusted incremental expenditures for individuals with hypertension versus those without hypertension. Sex, race/ethnicity, education, insurance status, census region, income, marital status, Charlson Comorbidity Index, and year category were included as covariates. The 2003–2014 pooled data include a total sample of 224 920 adults, of whom 36.9% had hypertension. Unadjusted mean annual medical expenditure attributable to patients with hypertension was $9089. Relative to individuals without hypertension, individuals with hypertension had $1920 higher annual adjusted incremental expenditure, 2.5 times the inpatient cost, almost double the outpatient cost, and nearly triple the prescription medication expenditure. Based on the prevalence of hypertension in the United States, the estimated adjusted annual incremental cost is $131 billion per year higher for the hypertensive adult population compared with the nonhypertensive population. Individuals with hypertension are estimated to face nearly $2000 higher annual healthcare expenditure compared with their nonhypertensive peers. This trend has been relatively stable over 12 years. Healthcare costs associated with hypertension account for about $131 billion. This warrants intense effort toward hypertension prevention and management.