Hypertension-associated hospitalizations and costs in the United States, 1979-2006

Abstract

Background and objective: In the USA, the prevalence of hypertension has been high and increasing in recent decades. Even so, little is known about the changes over time in hospitalizations and the economic burden associated with this epidemic. We examined hypertension-associated hospitalizations and costs from 1979 to 2006.

Methods: Using the National Hospital Discharge Survey and the costs of community hospitals in the USA, we analyzed the changes in hypertension-associated hospitalizations and costs over time. We included those hospitalizations with a primary or secondary diagnosis of hypertension among patients aged 25 years and above. We examined changes in costs by adjusting them into year 2008 dollars. The costs included hospital expenses of payroll, employee benefits, professional fees and supplies.

Results: From 1979-1982 to 2003-2006, the proportion of hospitalizations that were associated with hypertension (primary or secondary diagnosis) increased from 1.9% to 5.4%. Among all hypertension-associated hospitalizations, the proportion with a secondary diagnosis of hypertension increased from 81.8% to 95.1%. In 2008 dollars, annual costs for hypertension-related hospitalizations increased from US$40 billion (5.1% of total hospital costs) during 1979-1982 to US$113 billion (15.1% of total hospital costs) during 2003-2006.

Conclusions: Both the proportions of hospitalizations that were associated with hypertension and the adjusted annual costs of such hospitalizations nearly tripled over the past 28 years. The increases were in substantial measure due to the greatly increasing proportion of hospitalizations in which hypertension was listed as a secondary diagnosis. Interventions for the management of hypertension as a secondary diagnosis might be potentially cost-effective.

Conflict of interest statement

Disclosure: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention. The authors declared no conflict of interest.

Figures

Figure 1

Age-standardized hypertension hospitalization, total and by first and second diagnosis.

Figure 2

Age-standardized hospitalization rates for hypertension by sex.

Figure 3

Age-standardized hypertension-related hospitalization by age, 1979 – 2006.