title: [The analysis of drug cost and direct medical expense in community health management of hypertensive patients].
abstract: OBJECTIVE
  To investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics.
  
  
  METHODS
  A total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year (from November 2009 to November 2010) were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed.
  
  
  RESULTS
  The average annual drug cost in hypertension was (621.50 ± 1337.78) yuan per patient; while the cost was (616.13 ± 1248.40) yuan in management group and (626.44 ± 1414.30) yuan in control group respectively. The average annual drug cost of hypertensive patients who took medicine therapy was (702.05 ± 1401.79) yuan per person, while the cost in the management group ((688.50 ± 1300.70) yuan) was much lower than it in control group ((714.64 ± 1489.60) yuan). The annual average drug cost in urban was (731.88 ± 1403.31) yuan per person, which was higher than it in rural as (407.44 ± 1171.44) yuan per person. The average hospitalized rate was 12.2% (1014/8326), and the average annual cost among the hospitalized patients was (9264.47 ± 18 088.49) yuan per person; while the cost was (7583.70 ± 13 267.00) yuan in management group, which was lower than it in control group as (11 028.00 ± 21 919.00) yuan. The average annual hospitalized cost in hypertension was (1064.87 ± 6804.83) yuan per person; while the cost was (936.73 ± 5284.90) yuan in management group, which was lower than it in control group as (1181.50 ± 7937.90) yuan. The average annual direct medical expense in hypertension was (2275.08 ± 8225.66) yuan per person; while the expense was (2165.10 ± 6564.60) yuan in management group and (2375.20 ± 9487.60) yuan in control group. The average annual direct medical expense in urban ((2801.06 ± 9428.54) yuan per person) was higher than it in rural ((1254.70 ± 4990.27) yuan per person).
  
  
  CONCLUSIONS
  The community health or standardized management of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.
authors.affiliation: State Key Laboratory of Translational Cardiovascular Medicine, Fuwai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
authors.forename: Xiao-hua
authors.initials: XH
authors.lastname: Liang
authors.forename: Dong-feng
authors.initials: DF
authors.lastname: Gu
authors.forename: Huan
authors.initials: H
authors.lastname: Zhang
authors.forename: Kun
authors.initials: K
authors.lastname: Zhu
authors.forename: Ying
authors.initials: Y
authors.lastname: Deng
authors.forename: Jie
authors.initials: J
authors.lastname: Cao
authors.forename: Zheng-yuan
authors.initials: ZY
authors.lastname: Zhou
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Guo-sheng
authors.initials: GS
authors.lastname: Wan
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhao
authors.forename: Quan-cheng
authors.initials: QC
authors.lastname: Mu
authors.forename: Fang-hong
authors.initials: FH
authors.lastname: Lu
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011634:Public Health / Q000191:economics