Research of Economic Burden Attributable to Hypertension for Chinese Elderlies based on Multivariate linear regression model

Abstract

Background: Multivariate linear regression model is a reliable type of predictive analysis, which perfectly accord with the object of estimating and predicting the economic burden attributable to hypertension. Multivariate linear regression model can estimate how influential covariates are in predicting an explained variable, which variables are significant predictors of the dependent variable, in what way do they impact the outcome variable, and how the following trend will develop. Objectives This study aims to estimate the trend of inpatient and outpatient medical burden attributable to hypertension from 2011 to 2015. Method: Data for this study was from the China Health and Retirement Longitudinal Survey (CHARLS) 2011, 2013, and 2015, a comprehensive and nationally representative survey of Chinese residents aged 45 and older. The sample sizes in 2011, 2013, and 2015 are respectively 17705, 18605, and 21095. This study uses a set of three multivariate linear regressions to estimate increments of outpatient and inpatient costs. Results: On average, the outpatient cost of medical treatment for hypertension is 9.84 yuan (95%CI: [3.33yuan, 16.35yuan]) per month. Further statistical evidence reveals that the outpatient costs attributable to HBP in 2013 and 2015 are not significant. The total cost of outpatient service and treatment in 2013 is 22.17 yuan (95%CI: [12.62yuan, 31.72yuan]), while the number in 2015 accounts for 23.43 yuan (95% CI [13.57yuan, 33.26 yuan]). Outpatient medical cost attributable to for female is 18.28(95%CI: [11.73yuan, 24.83yuan]) yuan. The cost of outpatient medical care without public insurance is 15.23 yuan (95%CI: [1.34yuan, 29.11yuan]). The outpatient medical cost attributable to a high-income level is 20.48 yuan (CI: [12.65-yuan, 28.31 yuan]). The cost of outpatient medical care attribute to the western population was 13.57-yuan (95% CI: [5.32-yuan, 21.83 yuan]) yuan. Education, marital status and agricultural or nonagricultural workforce are not significant factors for outpatient HBP. The average inpatient medical cost for hypertension is 184.56 yuan (95% CI: [104.29-yuan, 264.82 yuan]) per year. The total inpatient medical cost in 2013 is 213.92 yuan (95% CI: [96.16-yuan, 331.68 yuan]). The total inpatient medical cost in 2015 is 268.27 (95% CI [146.78-yuan, 389.77 yuan]) yuan. Inpatient medical costs attributable to HBP in 2013 and in 2015 are not significant. The inpatient medical cost attributable to non-agriculture population over agriculture population is 259.49 yuan (95% CI: [155.28-yuan, 363.70 yuan]). Patients who live without a spouse spend 247.67 yuan (95% CI: [144.38-yuan, 350.96 yuan]). Furthermore, those who are not covered by public insurance on average spend 269.38 yuan (95% CI: [98.20 yuan, 440.55 yuan]). Inpatient medical cost attributable to a high-income level is 183.08 yuan (95% CI: [86.59yuan, 279.57yuan]). For those who live in the western part of China, the mean expenditure on hospitalized treatment is 133.11(95% CI: [31.35yuan, 234.88yuan]). Noticeably, this is the area that is less well-off compared to the metropolises along the eastern coast. Therefore, it can be inferred that education and gender are not significant factors for inpatient HBP. Conclusion: Among the elderly population aged 45 and above in China, the medical expenditure on inpatient and outpatient services of hypertensive patients is significantly higher compared to other age groups. However, the incremental cost of hypertension remained stable while the incremental cost of total medical expenses increased gradually. Thus, HBP may be under control while comorbidities and side effects subsequently increase the medical cost. The sample characteristics chart tells us that HBP is a detection problem rather than treatment problem. Hence, specific demographic groups need to raise awareness of the medical condition.