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Prehypertension, hypertension in children drive up health care costs
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Prehypertension and hypertension in children are having strong effects on health care costs, according to research published in The American Journal of Managed Care.
Although BMI was also found to influence costs in the study at integrated health systems in Colorado and Minnesota, the researchers noted that accurate assessment requires adjusting for blood pressure (BP) status.
“These findings are relevant to ongoing clinical and public policy discussions,” the researchers wrote. “First, they suggest that greater attention should be paid to elevated BP in children and adolescents as a driver of health care costs. Second, elevated BP has a significant effect on cost independent from elevated BMI and other comorbid conditions. Third, studies that do not account for the impact of BP level on utilization may overestimate the effect of BMI on utilization and costs.”
Todd P. Gilmer, PhD, of the Department of Family and Preventive Medicine, University of California, San Diego, and colleagues from other institutions, conducted a prospective dynamic cohort study of 71,617 children aged 3 to 17 years between January 2007 and December 2011.
Todd P. Gilmer
The researchers used generalized linear models to calculate annual estimates of total, inpatient, outpatient and pharmacy costs, as well as outpatient utilization and receipt of diagnostic and evaluation tests related to BP status and BMI status.
Overall yearly costs were significantly lower in children with normal BP ($736, standard error –[SE]=$15) and prehypertension ($945, SE=$10) than children with hypertension ($1972, SE=$74; P<.001 for each comparison) with adjustments for BMI.
Overall yearly costs for children below the 85th percentile for BMI ($822, SE=$8) was significantly reduced compared with children between the 85th and 95th percentiles ($954, SE=$45) and children at or above the 95th percentile ($937, SE=$13; P <.001, each), with adjustments for hypertension.
“While we do not have the data to examine whether lowering BP in those with elevated BP would reduce their health care cost, it seems reasonable to suggest this may occur,” the researchers wrote.
Disclosures: This study was funded by the NIH through the National Heart, Lung and Blood Institute.
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