Medical care expenditures for hypertension, its complications, and its comorbidities
Medical care expenditures for hypertension, its complications, and its comorbidities
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DOI：
10.1097/00005650-200106000-00008
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发表时间：
2001-06-01
期刊：
影响因子：
3
通讯作者：
Cai, LM
中科院分区：
文献类型：
--
作者：
Hodgson, TA;Cai, LM
目标。估计了高血压的医疗支出，包括心血管并发症、高血压患者风险较高的其他疾病以及增加医疗费用的合并症（二次诊断）的支出。本文介绍了1998年美国按性别、年龄和卫生服务类型分列的总、人均和每种情况的支出。1998年，各种国家数据来源被用来按诊断分列国家卫生支出。心血管并发症和高血压患者使用率较高的其他疾病的支出通过归因风险分析确定。通过回归分析估计额外住院天数和疗养院和家庭健康护理对合并症的更高收费所产生的额外支出。1998年，用于高血压的保健支出为1 088亿美元，占可用于诊断的全国总支出的12.6%，其中用于高血压的支出为228亿美元，用于心血管并发症的支出为297亿美元，用于其他诊断的支出为564亿美元。人均支出随着年龄的增长而增加，从65岁以下的249美元增加到85岁以上的3,007美元。每个高血压病症的平均花费为3787美元。女性的支出普遍较高。高血压的经济负担很大，但与高血压直接相关的卫生服务只占归因支出的一小部分。全面核算支出更准确地评估高血压的成本和预防和治疗可能节省的费用。生活方式的改变和医疗干预为减少国家卫生支出提供了机会。
OBJECTIVES. Medical expenditures attributed to hypertension were estimated, including expenditures for cardiovascular complications, other conditions for which hypertensives are at higher risk, and comorbidities (secondary diagnoses) that raise the cost of medical care. This article presents total, per capita, and per condition US expenditures in 1998 according to sex, age, and type of health service.METHODS. A variety of national data sources were used to disaggregate national health expenditures in 1998 by diagnosis. Expenditures for cardiovascular complications and other conditions for which hypertensives had higher rates of utilization were determined by analysis of attributable risks. Additional expenditures generated by extra hospital inpatient days and higher charges for nursing home and home health care for comorbidities were estimated by regression analyses.RESULTS. In 1998, $108.8 billion in health care spending was attributed to hypertension, 12.6% of total national spending that could be allocated to diagnoses, including $22.8 billion for hypertension, $29.7 billion for cardiovascular complications, and $56.4 billion for other diagnoses. Per capita expenditures increased with age from $249 for those younger than 65 years to $3,007 for those 85 years and older. The average amount spent per hypertensive condition was $3,787. Expenditures were generally higher for females.CONCLUSIONS. The economic burden of hypertension is large, but health services directly related to hypertension account for only a fraction of attributed expenditures. Comprehensive accounting of expenditures more accurately assesses the cost of hypertension and potential savings from prevention and treatment. Alteration of lifestyles and medical intervention provide opportunities to reduce national health expenditures.