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Medical Costs, Health Care Utilization, and Productivity Losses Associated With Hypertension Moderated by COVID-19
Jun Soo Lee1, Yidan Xue Zhang1,2, Yu Wang3,4
1Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Hypertension significantly increases medical costs, healthcare use, and lost workdays. These burdens are worsened by COVID-19, highlighting the need for better hypertension management.
Area of Science:
- Health Economics
- Public Health
- Epidemiology
Background:
- Hypertension is a primary risk factor for cardiovascular and renal diseases.
- The COVID-19 pandemic amplified concerns regarding hypertension's impact on severe COVID-19 outcomes.
Purpose of the Study:
- To evaluate the economic and healthcare utilization burden of hypertension.
- To assess the exacerbating effect of COVID-19 on individuals with hypertension.
Main Methods:
- Analysis of 2020-2021 US employer-sponsored insurance claims data for adults aged 18-64.
- Comparison of medical costs, healthcare utilization, and productivity losses between hypertensive and non-hypertensive individuals, stratified by COVID-19 status.
- Multivariable regression models adjusted for demographics and comorbidities.
Main Results:
- Hypertension was associated with $8,572 in excess medical costs and increased healthcare utilization (ED visits, inpatient admissions, outpatient visits, prescriptions) per patient over two years.
- Individuals with hypertension experienced more sick absences and short-term disability (STD) days.
- Among those with hypertension, COVID-19 diagnosis correlated with an additional $3,495 in medical costs and 2.588 more STD days.
Conclusions:
- Hypertension is linked to substantial increases in medical costs, healthcare utilization, and productivity losses.
- The impact of hypertension on these outcomes is amplified in the presence of COVID-19.
Background:
Hypertension is a major risk factor for cardiovascular and renal diseases, significantly contributing to morbidity and mortality. The COVID-19 pandemic has heightened concerns about the impact of hypertension on severe COVID-19 outcomes.
Methods:
We analyzed 2020-2021 data from the MarketScan Commercial and Health and Productivity Management databases, focusing on adults aged 18-64 years with continuous employer-sponsored private insurance, excluding pregnancy or capitated plans. We compared medical costs, healthcare utilization (emergency department [ED] visits, inpatient admissions, outpatient visits, and outpatient prescription drugs), and productivity losses (sick absences, short-term disability [STD], and long-term disability) between individuals with and without hypertension, stratified by COVID-19 diagnosis. We used multivariable regression models, including an interaction term for hypertension and COVID-19 diagnosis, to estimate differences in outcomes, adjusting for demographics and comorbidities.
Results:
Among 1,296,596 adults, 21% had hypertension. Those with hypertension were older, less likely female, less likely urban residents, and had more comorbidities. Excess medical costs associated with hypertension were $8,572 per patient over the 2-year period (95% CI $8,182-$8,962). Patients with vs. without hypertension had 0.200 (95% CI, 0.195-0.205) more ED visits, 0.081 (95% CI, 0.077-0.085) more inpatient admissions, 5.984 (95% CI, 5.892-6.075) more outpatient visits, and 20.25 (95% CI, 20.09-20.41) more prescriptions per patient over the 2-year period. They also had more sick absences (1.13 days; 95% CI 0.93-1.34) and STD occurrences (3.88 days; 95% CI 3.56-4.20) per patient. Among those with hypertension, individuals with vs. without COVID-19 had $3,495 (95% CI, $2,135-$4,856) higher medical costs and 2.588 (95% CI, 1.112-4.065) more STD days per patient over the 2-year period.
Conclusions:
Hypertension was associated with higher medical costs, healthcare utilization, and productivity losses, exacerbated by COVID-19.
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