Department of Public Health, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.
J Epidemiol. 2010;20(3):192-6. doi: 10.2188/jea.je20081027. Epub 2010 Mar 6.
This retrospective cohort study examined the sex- and age-specific impact of hypertension on medical expenditures.
In 2006, we analyzed the medical expenditure records of 42 426 Japanese National Health Insurance beneficiaries (16 169 men, 26 257 women) who lived in Ibaraki, Japan, were aged 40 to 69 years, and underwent health checkups in 2002. Blood pressure was classified into 4 categories according to the criteria outlined in the seventh report of the Joint National Committee.
The difference in median total expenditure between the hypertension categories and the normotension category was 119 585 yen (140 360 yen vs 20 775 yen) for men aged 40 to 54 years, 126 160 yen (204 070 yen vs 77 910 yen) for men aged 55 to 69 years, 125 495 yen (158 025 yen vs 32 530 yen) for women aged 40 to 54 years, and 122 370 yen (208 700 yen vs 86 330 yen) for women aged 55 to 69 years. The median total and outpatient medical expenditures markedly differed between patients with stage 1 hypertension and stage 2 hypertension (which included people on antihypertensive medication) in both sexes and all age subgroups. The median total and outpatient medical expenditures were higher among women than among men in all blood pressure categories.
The impact of hypertension on medical expenditures was similar in all age groups. Therefore, from the perspective of medical economics, prevention of the onset of hypertension seems equally important for all age subgroups.
本回顾性队列研究考察了高血压对医疗支出的性别和年龄特异性影响。
2006 年，我们分析了居住在日本茨城县、年龄在 40 至 69 岁之间、2002 年接受健康检查的 42426 名日本国民健康保险受益人（男性 16169 人，女性 26257 人）的医疗支出记录。血压根据第七次联合国家委员会报告中的标准分为 4 类。
在年龄为 40 至 54 岁的男性中，高血压组与正常血压组之间的总支出中位数差异为 119585 日元（140360 日元比 20775 日元），在年龄为 55 至 69 岁的男性中为 126160 日元（204070 日元比 77910 日元），在年龄为 40 至 54 岁的女性中为 125495 日元（158025 日元比 32530 日元），在年龄为 55 至 69 岁的女性中为 122370 日元（208700 日元比 86330 日元）。在所有性别和年龄亚组中，男女患者的 1 期高血压和 2 期高血压（包括服用抗高血压药物的患者）之间的总支出和门诊支出中位数差异显著。在所有血压类别中，女性的总支出和门诊支出中位数均高于男性。
高血压对医疗支出的影响在所有年龄组中相似。因此，从医疗经济学的角度来看，预防高血压的发生对于所有年龄组同样重要。
