title: Hospitalization costs associated with hypertension as a secondary diagnosis among insured patients aged 18-64 years.
abstract: BACKGROUND
  We estimated the hospitalization costs associated with hypertension as a secondary diagnosis among insured adults aged 18-64 years by using data from 2005 MarketScan Commercial Claims and Encounters (CCAE) inpatient admissions.
  
  
  METHODS
  We analyzed costs for four patient groups (N = 455,944): (i) all selected patients; (ii) patients with the primary diagnosis of ischemic heart disease (IHD); (iii) patients with the primary diagnosis of cerebrovascular disease; and (iv) patients with neither IHD nor cerebrovascular disease as the primary diagnosis. We conducted propensity score matching to control possible bias in cost estimates due to sample selections and estimated the costs of hypertension by using a regression model on the matched populations that controlled for subjects' age, sex, length of hospital stay, Charlson comorbidity index (CCI), region of residence, and urbanization of residence.
  
  
  RESULTS
  For all patients with hypertension as a secondary diagnosis, the estimated average annual hospitalization cost per patient was $21,094, of which $2,734 (13%; P < 0.01) was associated with hypertension. The estimated average costs were $31,106 for patients with a primary diagnosis of IHD, $17,298 for those with a primary diagnosis of cerebrovascular disease, and $18,693 for those without a primary diagnosis of IHD or cerebrovascular disease; hypertension-associated costs for these patients were $3,540 (11.4%; P < 0.01), $1,133 (6.5%; P < 0.01), and $2,254 (12.1%; P < 0.01), respectively.
  
  
  CONCLUSIONS
  Hypertension-associated hospitalization costs are substantial among insured US patients aged 18-64 years with hypertension as a secondary diagnosis and suggest a need for cost-effective programs to prevent, manage, and control hypertension.
authors.affiliation: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. gbw9@cdc.gov
authors.forename: Guijing
authors.initials: G
authors.lastname: Wang
authors.forename: Zefeng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Carma
authors.initials: C
authors.lastname: Ayala
mesh_terms: D000293:Adolescent; D000328:Adult; D002561:Cerebrovascular Disorders / Q000150:complications; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000191:economics* / Q000628:therapy; D007345:Insurance Claim Review; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D014481:United States; D055815:Young Adult