Impact of poorly controlled hypertension on healthcare resource utilization and cost.
OBJECTIVE
To examine the relation between blood pressure (BP) control and utilization and cost of healthcare resources.


METHODS
A retrospective database study of managed care patients in New Mexico from January 1, 1996, to December 31, 1997.


METHODS
We stratified 1000 hypertensive patients into categories based on average and maximum BP. Antihypertensive medication use and cost, number of physician visits, and interval between hypertension-related physician visits were determined.


RESULTS
Medication costs increased progressively across all BP categories from lowest to highest, and higher average systolic BP (SBP) was significantly correlated with increased cost (P < .001). There were significant correlations between higher maximum BP and greater number of hypertension-related physician visits (P < .001). Mean number of visits for BP groups was 5.5 for patients with a maximum diastolic BP (DBP) < 85 mm Hg and 10.0 for those with a maximum DBP > or = 100 mm Hg (P < .001). Patients with a maximum SBP > or = 180 mm Hg averaged 9.7 visits, whereas those with a maximum SBP < 120 mm Hg averaged 4.1 visits (P < .001). Both SBP and DBP were significantly correlated with time to next visit (P < .001). Mean visit intervals ranged from 44 days for patients with an SBP < 85 mm Hg to 25 days for those with an SBP > or = 180 mm Hg (P < .001). A similar association was found between DBP and visit interval.


CONCLUSIONS
Poor control of hypertension is associated with higher drug costs and more physician visits. Aggressive treatment might help reduce managed care costs and resource utilization.
Paramore
L C
LC
MSPH, MEDTAP International, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, USA. paramore@medtap.com
Halpern
M T
MT
Lapuerta
P
P
Hurley
J S
JS
Frost
F J
FJ
Fairchild
D G
DG
Bates
D
D
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D017281:Cost of Illness; D016527:Drug Costs; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics*; D009516:New Mexico; D009819:Office Visits / Q000706:statistics & numerical data*; D010349:Patient Compliance; D012189:Retrospective Studies; D014600:Utilization Review
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents