Division of Workforce Development, Public Health Infrastructure Center, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Science and Evaluation Team, American Heart Association, Dallas, Texas.
Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2024 Dec;67(6):820-831. doi: 10.1016/j.amepre.2024.07.005. Epub 2024 Jul 11.
This study seeks to estimate health care expenditures and use associated with hypertension, focusing on differences among racial and ethnic groups.
Data were from the 2019 Medical Expenditure Panel Survey, analyzed in 2023. The study sample included noninstitutionalized U.S. adults aged ≥18 years. Outcome variables were health care expenditures and events. Hypertension was determined by a self-reported diagnosis or diagnosis codes. Race and ethnicity were self-reported. A 2-part model was used to estimate expenditures associated with hypertension. A zero-inflated negative binomial model was used to estimate events associated with hypertension. Sampling designs were applied to generate nationally representative estimates.
Hypertension was associated with $2,759 (95% confidence interval [CI]: $2,039, $3,479) in health care expenditures and 10.3 (95% CI: 9.3, 11.3) health care events, including prescriptions filled, in 2019 per person. Compared with non-Hispanic White adults, hypertension-associated health care expenditures were significantly lower among Hispanic adults (difference: -$1,877; 95% CI: -$3,389, -$364) and Asian adults (difference: -$2,452; 95% CI: -$4,093, -$811), and hypertension-associated health care events were significantly lower among Hispanic adults (difference: -3.8; 95% CI: -6.1, -1.6) and non-Hispanic Asian adults (difference: -4.1; 95% CI: -6.9, -1.2). Differences between non-Hispanic White adults and non-Hispanic Black adults were not statistically significant in health care expenditures (difference: -$954; 95% CI: -$2,849, $941) and events (difference: 0.3; 95% CI: -2.1, 2.8).
This study reveals differences in health care expenditures and use associated with hypertension among racial and ethnic groups. Future studies are needed to examine potential drivers of these differences.
本研究旨在评估与高血压相关的医疗支出和使用情况，重点关注不同种族和族裔群体之间的差异。
数据来自 2019 年医疗支出面板调查，于 2023 年进行分析。研究样本包括非机构化的美国 18 岁及以上成年人。结果变量是医疗支出和事件。高血压通过自我报告的诊断或诊断代码确定。种族和族裔是自我报告的。使用两部分模型来估计与高血压相关的支出。使用零膨胀负二项模型来估计与高血压相关的事件。应用抽样设计生成全国代表性估计值。
2019 年，每人为高血压相关的医疗支出为 2759 美元（95%置信区间[CI]：2039 美元，3479 美元），医疗事件为 10.3（95%CI：9.3，11.3），包括处方数量。与非西班牙裔白人成年人相比，西班牙裔成年人（差异：-1877 美元；95%CI：-3389 美元，-364 美元）和亚裔成年人（差异：-2452 美元；95%CI：-4093 美元，-811 美元）高血压相关的医疗支出显著较低，西班牙裔成年人（差异：-3.8；95%CI：-6.1，-1.6）和非西班牙裔亚裔成年人（差异：-4.1；95%CI：-6.9，-1.2）高血压相关的医疗事件显著较低。非西班牙裔白人和非西班牙裔黑人间的医疗支出（差异：-954 美元；95%CI：-2849 美元，941 美元）和事件（差异：0.3；95%CI：-2.1，2.8）差异无统计学意义。
本研究揭示了不同种族和族裔群体中与高血压相关的医疗支出和使用的差异。需要进一步研究以探讨这些差异的潜在驱动因素。
