Comorbidity Status and Annual Total Medical Expenditures in U.S. Hypertensive Adults

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Park, Chanhyun ; Fang, Jing ; Hawkins, Nikki A. ; Wang, Guijing
• Description:
  Introduction
  
  The purpose of this study is to investigate comorbidity status and its impact on total medical expenditures in non-institutionalized hypertensive adults in the U.S.
  
  Methods
  
  Data from the 2011–2014 Medical Expenditure Panel Survey were used. Patients were included if they had a diagnosis code for hypertension, were aged ≥18 years, and were not pregnant during the study period (N=26,049). The Elixhauser Comorbidity Index was modified to add hypertension-related comorbidities. The outcome variable was annual total medical expenditures, and a generalized linear model regression (gamma distribution with a log link function) was used. All costs were adjusted to 2014 U.S. dollars.
  
  Results
  
  Based on the modified Elixhauser Comorbidity Index, 14.0% of patients did not have any comorbidities, 23.0% had one, 24.4% had two, and 38.7% had three or more. The five most frequent comorbidities were hyperlipidemia, diabetes, rheumatoid arthritis, depression, and chronic pulmonary disease. Estimated mean annual total medical expenditures were $3,914 (95% CI= $3,456, $4,372) for those without any comorbidity; $5,798 (95% CI=$5,384, $6,213) for those with one comorbidity; $8,333 (95% CI=$7,821, $8,844) for those with two comorbidities; and $13,920 (95% CI=$13,166, $14,674) for those with three or more comorbidities. Of the 15 most frequent comorbidities, the condition with the largest impact on expenditures for an individual person was congestive heart failure ($7,380). Hypertensive adults with stroke, coronary heart disease, diabetes, renal diseases, and hyperlipidemia had expenditures that were $6,069, $6,046, $5,039, $4,974, and $4,851 higher, respectively, than those without these conditions.
  
  Conclusions
  
  Comorbidities are highly prevalent among hypertensive adults, and this study shows that each comorbidity significantly increases annual total medical expenditures.
  
  
• Subjects:
  Adult Aged Arthritis, Rheumatoid Chronic Disease Cost Of Illness Depression Diabetes Mellitus Female Health Expenditures Humans Hyperlipidemias Hypertension Lung Diseases Male Middle Aged Multimorbidity Pregnancy Prevalence Surveys And Questionnaires United States Young Adult

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• Source:
  Am J Prev Med. 53(6 Suppl 2):S172-S181
• Pubmed ID:
  29153118
• Pubmed Central ID:
  PMC5836318
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/ ; U36 OE000005/OE/OSELS CDC HHSUnited States/
• Volume:
  53
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2246437413905a48b6efbe51fe3cb5bbe7853e0f3ef2738f9b3b5bc18c4760e7
• Download URL:
  https://stacks.cdc.gov/view/cdc/52362/cdc_52362_DS1.pdf
• File Type:
  [PDF - 460.10 KB ]