[Analysis of direct costs of controlling arterial hypertension].

OBJECTIVE

To analyse the number of attendances and the direct cost of pharmaceutical prescription arising from a year-long monitoring of hypertense patients.

SETTING

Health Centre.

DESIGN

A prospective observation study.

PATIENTS

220 hypertense patients, undergoing arterial pressure (AP) monitoring, were chosen by means of systematic random sampling.

MEASUREMENTS AND MAIN RESULTS

The variables of age, gender, cardiovascular risk factors, AP, monitoring level (criterion AP < 160-90 mmHg), attendances and treatment used were analysed. The pharmaceutical cost was calculated in line with the dosages and according to the 1990 Vademecum. The monitoring level was 43.6%. The total number of attendances per patient were 12.8 +/- 6.43 and those for hypertension, 7.9 +/- 3.5. Diabetics attended more for hypertension (8.8 vs 7.5, p < 0.05). Pharmaceutical treatment was prescribed for 183 people (83.2%). The number of drugs was correlated with the severity of the hypertension and the number of attendances. Overall drug cost was 429,571 pesetas per month. Average monthly cost per patient was 2,348.69 +/- 2,318.92 pesetas (range 90.5-12,856.5). Angiotensin enzyme conversion inhibitors (AECI) made for the greatest monthly mean cost per patient (4,352.9 pesetas) and diuretics, the least (322.2 pesetas).

CONCLUSION

Frequency of attendance is related to the presence of diabetes and the number of drugs prescribed. The introduction of AECI and Calcium antagonists into first-line treatment represents an important increase in the cost of controlling Hypertension.