Hypertension-Associated Medical Expenditures by Diabetes Status among Adult Female Medicaid Enrollees in Alabama

Abstract

Little information is available on how diabetes status affects medical expenditures associated with hypertension among Medicaid enrollees. In 2013, Alabama had the highest proportion of Medicaid enrollees who were women and the highest hypertension prevalence in the U.S. We estimated hypertension-associated medical expenditures among adult female Medicaid enrollees by diabetes status in Alabama. We used data for 15,885 female Medicaid enrollees aged 19-64 years from the 2012 Medicaid Analytic extract files. We identified persons with hypertension and diabetes using ICD-9 codes. We used General Linear Models to estimate per person total annual medical expenditures associated with hypertension by diabetes status and hypertension-related conditions including myocardial infarction, congestive heart failure, peripheral vascular disease, chronic pulmonary disease, renal disease, and stroke. Overall hypertension prevalence was 20.8%, with 60.0% and 17.5% among those with and without diabetes, respectively. Annual medical expenditure per enrollee with hypertension was $7,722. After controlling for age, race, and Charlson comorbidity index, hypertension-associated excess annual medical expenditures were $2,540 and $2,926 for persons with and without diabetes (all p<0.01). For persons without hypertension-related conditions, the excess expenditures were $1,931 and $2,533 for those with and without diabetes (all p<0.01). For persons with at least one hypertension-related condition, these excess expenditures increased to $4,217 and $3,264, respectively (all p<0.01). Having hypertension increased medical expenditures greatly regardless of diabetes status. Having a hypertension-related condition further increased hypertension-associated medical expenditures among enrollees, especially in those with diabetes. These results can inform the development and evaluation of strategies to improve management of hypertension by diabetes status. Disclosure G. Wang: None. B. Ng: None. C. Park: None. J. Fang: None. M. Ritchey: None. R. Soler: None. B. Smith: None. P. Zhang: None.