Impact of hypertension on medical economics: A 10-year follow-up study of national health insurance in Shiga, Japan.
Hypertension and related cardiovascular diseases may lead to an increase in medical costs for patients. We attempted to clarify the relationship between hypertension and long-term medical costs by a cohort study utilizing existing data as well as baseline blood pressures and medical costs over a 10-year period. The participants included 4191 Japanese National Health Insurance beneficiaries aged 40-69 years, living in one area, who were not taking anti-hypertensive medication and did not have a history of major cardiovascular disease. They were classified into four categories according to their blood pressure. We evaluated the mean medical costs per month, cumulative hospitalization, and all-cause mortality for each blood pressure category. Hypertension-related medical costs attributable to hypertensive individuals, as compared to normotensive individuals, were estimated. There was a positively graded correlation between blood pressure and personal total medical costs, especially for men. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensive men were also higher than those in normotensive men. However, the hypertension-related medical costs for mild to moderate hypertensives were higher than those for severe hypertensives. The hypertension-related medical costs for all hypertensives accounted for 23.7% of the total medical costs for the Japanese population. In conclusion, high blood pressure was a useful predictor for excess medical costs; moreover, concomitant hypertension, regardless of the grade, increased the medical costs of Japanese National Health Insurance beneficiaries.
Department of Health Science, Shiga University of Medical Science, Otsu, Japan. ksnkmr@belle.shiga-med.ac.jp
Koshi
K
Nakamura
Tomonori
T
Okamura
Hideyuki
H
Kanda
Takehito
T
Hayakawa
Takashi
T
Kadowaki
Akira
A
Okayama
Hirotsugu
H
Ueshima
D000328:Adult; D000368:Aged; D044466:Asian People; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D006973:Hypertension / Q000191:economics*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009313:National Health Programs