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Hypertension-related hospitalizations and treatment charges rose among children
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Pediatric hypertension-related hospitalizations in the United States nearly doubled from 1997 to 2006, according to study results from the American Heart Association. Mean hospitalization charges for children with hypertension also rose by 50%, accounting for an estimated $3.1 billion in inpatient health care charges during the same period.
“The frequency of hypertension hospitalizations is rising, fraction of charges attributed to hypertension are increasing, and hospitalization of children with hypertension and end-stage renal disease results in significant increases in health care charges,” study researcher Cheryl L. Tran, MD, of the University of Michigan, told Healio.com
Tran and colleagues analyzed discharge records for 1997, 2000, 2003 and 2006, obtained from the Healthcare Cost and Utilization Project Kids’ Inpatient Database, an all-payer health care database for children in the United States. The researchers performed logistic and linear regression analyses to determine the number of hypertension-related hospitalizations and associated charges over time.
Results showed that pediatric hypertension-related hospitalizations in the United States rose from 12,661 in 1997 to 24,602 in 2006. From 1997 to 2006, there were 38,803 hospital discharges with a primary or secondary diagnosis of hypertension in children aged 2 to 18 years, representing an estimated 71,282 discharges nationally. Among those hospitalized, approximately 68% were aged 10 to 18 years, a higher frequency attributed to the rise in obesity prevalence. The mean charge for hypertension-related hospitalizations rose from $35,600 in 1997 to $53,500 in 2006 — greater than all other hospitalizations — and the average length of stay was twice as long as other illnesses (8.1 days vs. 3.8 days). Pediatric hospitalizations charges related to hypertension increased from 2.2% to 4% between 1997 and 2006 (P,.0001).
Children hospitalized with hypertension were more likely to be aged older than 9 years, male and treated at a teaching hospital, according to researchers. The most common diagnoses in pediatric hospitalizations were pneumonia (3.8%), appendicitis (3%) and asthma (2.3%). When hypertension was the primary diagnosis, convulsive disorder (4.7%), headache (2.6%), obesity (2.4%) and systemic lupus erythematosus (2.4%) were the most common secondary diagnoses. When hypertension was part of any diagnosis, systemic lupus erythematosus (3.4%), complications of kidney transplant (1.9%), pneumonia (1.7%) and acute proliferative glomerulonephritis (1.7%) were the most common primary diagnoses.
Tran said increasing hospitalizations may be due in part to the rise in childhood obesity.
“However, our analyses using discharge data provided by the Healthcare Cost and Utilization Project Kids’ Inpatient Database may be limited by the accuracy of coding, which could affect the ability to identify obesity. A child with high blood pressure is at increased risk of developing high blood pressure in adulthood and the long-term complications that are associated with that disease,” she said. “This study expands our understanding of the impact of hypertension in children in the hospital setting and augments previous ambulatory literature. It provides some insight to the economic burden of pediatric hypertension, which brings the question of how can this be prevented? By counseling families and providing education on healthy lifestyles such as diet and exercise, as well as identifying hypertension in children early on to provide the appropriate therapy, these may be the first steps toward preventing the disease and its complications.”
Disclosure: The researchers report no relevant financial disclosures.
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