Abstract
Background Hypertension is one of the commonest chronic diseases, yet limited data are available for related health care utilization. Our study objective was to describe the emergency department (ED) and subsequent hospitalization related health care utilization and charges due to hypertension in the U.S.MethodsWe used the National ED sample (NEDS) to study hypertension-related utilization and charges. Multivariable-adjusted linear or logistic regression was used to assess hypertension-associated ED and hospitalization outcomes (disposition, length of stay, charges), adjusted for patient demographic, comorbidity and hospital characteristics.ResultsThere were 0.92, 0.97 and 1.04 million ED visits (0.71–0.77 % of all ED visits) with hypertension as the primary diagnosis in 2009, 2010 and 2012, respectively; 23 % resulted in hospitalization. ED charges were $2.00, $2.27 and $2.86 billion, and for those hospitalized, total charges (ED plus inpatient) were $6.62, $7.09 and $7.94 billion, in 2009, 2010 and 2012, respectively. Older age (50 to 65 years), female sex, metropolitan area residence, South or West U.S. hospital location, private insurance and the presence of congestive heart failure were each associated with higher charges for an ED visit with hypertension as the primary diagnosis. Younger age, metropolitan residence, Medicaid insurance, hospital location in the Northeast and co-existing diabetes, gout, coronary heart disease, chronic obstructive pulmonary disease, hyperlipidemia and osteoarthritis were associated with higher risk, whereas male sex was associated with lower risk of hospitalization after ED visit for hypertension. In 2012, 71.6 % of all patients hospitalized with hypertension as the primary diagnosis were discharged home. Older age, metropolitan residence and most comorbidities were associated with lower odds, whereas male sex, payer other than Medicare, South or West U.S. hospital location were associated with higher odds of discharge to home.ConclusionsHypertension is associated with significant healthcare burden in the U.S. Future studies should assess strategies to reduce hypertension-associated cost and health care burden.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1563-7) contains supplementary material, which is available to authorized users.
Highlights
Hypertension is one of the commonest chronic diseases, yet limited data are available for related health care utilization
In 2012, Medicare was the primary payer for 43 %, and almost half of all emergency department (ED) visits for hypertension occurred in hospitals located in the Southern U.S, with only 16 % each in Northeastern and Western U.S and 20 % in the Midwest
We found that age
Summary
Hypertension is one of the commonest chronic diseases, yet limited data are available for related health care utilization. Our study objective was to describe the emergency department (ED) and subsequent hospitalization related health care utilization and charges due to hypertension in the U.S. Hypertension is one of the commonest chronic diseases. Hypertension is one of the commonest chronic diseases It affects 32.5 % of U.S adults [1]. Hypertension is the primary diagnosis for 38.9 million physician office visits annually in the U.S [1]. Hypertension and related renal disease are responsible for 27,853 deaths annually [1]. Hypertension cost the U.S approximately $49.9 billion in 2010,. As a chronic condition, hypertension is associated with high public health and cost burden
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