美国商业保险参保人群中，与高血压相关的医疗费用、医疗保健利用率及生产力损失受新冠病毒诊断的影响情况。

Medical Costs, Health Care Utilization, and Productivity Losses Associated with Hypertension Moderated by COVID-19 Diagnosis Among US Commercial Enrollees.

作者信息

Lee Jun Soo, Zhang Yidan Xue, Wang Yu, Park Joohyun, Kumar Ashutosh, Donald Bruce, Luo Feijun, Roy Kakoli

机构信息

Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

ASRT, Inc., Atlanta, Georgia.

出版信息

Am J Hypertens. 2025 May 13. doi: 10.1093/ajh/hpaf081.

DOI:10.1093/ajh/hpaf081

PMID:40355360

Abstract

BACKGROUND

Hypertension is a major risk factor for cardiovascular and renal diseases, significantly contributing to morbidity and mortality. The COVID-19 pandemic has heightened concerns about the impact of hypertension on severe COVID-19 outcomes.

METHODS

We analyzed 2020-2021 data from the MarketScan Commercial and Health and Productivity Management databases, focusing on adults aged 18-64 years with continuous employer-sponsored private insurance, excluding pregnancy or capitated plans. We compared medical costs, healthcare utilization (emergency department [ED] visits, inpatient admissions, outpatient visits, and outpatient prescription drugs), and productivity losses (sick absences, short-term disability [STD], and long-term disability [LTD]) between individuals with and without hypertension, stratified by COVID-19 diagnosis. We used multivariable regression models, including an interaction term for hypertension and COVID-19 diagnosis, to estimate differences in outcomes, adjusting for demographics and comorbidities.

RESULTS

Among 1,296,596 adults, 21% had hypertension. Those with hypertension were older, less likely female, less likely urban residents, and had more comorbidities. Excess medical costs associated with hypertension were $8,572 per patient over the two-year period (95% CI $8,182-$8,962). Patients with versus without hypertension had 0.200 (95% CI, 0.195-0.205) more ED visits, 0.081 (95% CI, 0.077-0.085) more inpatient admissions, 5.984 (95% CI, 5.892-6.075) more outpatient visits, and 20.25 (95% CI, 20.09-20.41) more prescriptions per patient over the two-year period. They also had more sick absences (1.13 days; 95% CI 0.93-1.34) and STD occurrences (3.88 days; 95% CI 3.56-4.20) per patient. Among those with hypertension, individuals with versus without COVID-19 had $3,495 (95% CI, $2,135-$4,856) higher medical costs and 2.588 (95% CI, 1.112-4.065) more STD days per patient over the two-year period.

CONCLUSIONS

Hypertension was associated with higher medical costs, healthcare utilization, and productivity losses, exacerbated by COVID-19.

摘要

背景

高血压是心血管和肾脏疾病的主要危险因素，对发病率和死亡率有显著影响。2019冠状病毒病（COVID-19）大流行加剧了人们对高血压对COVID-19严重后果影响的担忧。

方法

我们分析了MarketScan商业、健康和生产力管理数据库2020 - 2021年的数据，重点关注年龄在18 - 64岁、有持续雇主赞助的私人保险、排除妊娠或预付费计划的成年人。我们比较了有高血压和无高血压个体之间的医疗费用、医疗保健利用率（急诊科就诊、住院、门诊就诊和门诊处方药）以及生产力损失（病假、短期残疾[STD]和长期残疾[LTD]），并按COVID-19诊断进行分层。我们使用多变量回归模型，包括高血压和COVID-19诊断的交互项，来估计结果差异，并对人口统计学和合并症进行调整。

结果

在1,296,596名成年人中，21%患有高血压。患有高血压的人年龄更大，女性比例更低，城市居民比例更低，合并症更多。两年期间，与高血压相关的额外医疗费用为每位患者8,572美元（95%置信区间8,182 - 8,962美元）。有高血压的患者与无高血压的患者相比，两年期间每位患者的急诊科就诊次数多0.200次（95%置信区间，0.195 - 0.205），住院次数多0.081次（95%置信区间，0.077 - 0.085），门诊就诊次数多5.984次（95%置信区间，5.892 - 6.075），处方药多20.25种（95%置信区间，20.09 - 20.41）。他们每位患者的病假天数（1.13天；95%置信区间0.93 - 1.34）和STD发生天数（3.88天；95%置信区间3.56 - 4.20）也更多。在患有高血压的人群中，有COVID-19的个体与无COVID-19的个体相比，两年期间医疗费用高3,495美元（95%置信区间，2,135 - 4,856美元），每位患者的STD天数多2.588天（95%置信区间，1.112 - 4.065）。