papers

Cost of arterial hypertension according to levels of morbidity in primary care setting

Med Clin (Barc) 133:290-295. Published in Spanish.

Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España

BACKGROUND AND OBJECTIVE: To determine the health care cost and the labour incapacity of hypertension (AHT) according to different levels of morbidity in primary care setting (PC).

PATIENTS AND METHODS: Retrospective-multicentric design. Patients’ >/=40 year from seven teams of PC (year 2007) were included. Main measures: age, sex, cardiovascular co-morbidity, Charlson index and general morbidity levels (Adjusted Clinical Groups; low, moderate and high). It was established a model of direct costs (differentiating: fixed and variable [drugs, tests and referrals]) and indirect. Logistic regression analysis and ANCOVA was used for the model correction. Statistical significance: P<0.05.

RESULTS: The prevalence of hypertension was 28.4% (95% confidence interval [CI]: 27.4-29.4%), mean age 67.5 (11.7) years and 56.7% of female. 73.2% of patients had moderate co-morbidity (95% CI: 71.3-75.1%). The average/unit of the total cost was 1312 euro.1 (range, low co-morbidity: 633.1 euro, moderately: 1297.2 euro and high: 2307.8 euro, P<0.001). Healthcare cost represented 98.2% of the whole and medication 69.4%. Morbidity with high cardiovascular event (OR=3.5), smoking (OR=1.4) and obesity (OR=1.3), P=0.02 was associated. The correlation of the health cost and total cost with the episodes number was 51.4% and 50.6% respectively, P0.001.

CONCLUSIONS: Patients with AHT have a high health care cost, mainly in pharmacy. The total costs increase with age and level of general morbidity. The AHT should be considered in conjunction with other cardiovascular risk factors. The cost in work labour incapacity is low.

PMID: 19596366