ABSTRACT
BACKGROUND: Arterial hypertension is one of the main reasons for primary care consultations. This study is aimed at determining the relationship among the degree to which arterial hypertension is controlled, comorbidity and the direct costs in primary care. METHODS: Retrospective, multi-centre design. Subjects over 30 years of age pertaining to five primary care teams (2006) were included. CRITERIA: good control (<140/90 and <130/80 mmHg in diabetics and those with cardiovascular disease [CVD]. Main general measurements, CVD, Charlson index, casuistic/comorbidity (Adjusted Clinical Groups), clinical parameters and direct costs (fixed/semifixed and variable costs) [medications, tests and referrals]) Logic regression and ANCOVA for correcting the model, p<0.05. RESULTS: The prevalence of arterial hypertension was 26.5% (mean age: 67.1 years; males: 43.5%). Good control totalled 52.0% (CI: 51.2-52.8%). Poor control was independently related to diabetes (Odds Ratio=3.8), CVD (Odds Ratio=2.2) and males (Odds Ratio=1.2), p<0.001. The average/direct unit cost/year was 1,202.13 Euro vs. 1,183.55 Euro (p=0.032). CONCLUSIONS: Those individuals whose arterial hypertension was poorly controlled displayed a greater burden of morbidity and a similar healthcare cost in comparison to those under good control.
Subject(s)
Hypertension/therapy , Adult , Aged , Costs and Cost Analysis , Female , Humans , Hypertension/complications , Hypertension/economics , Male , Middle Aged , Primary Health Care , Retrospective StudiesABSTRACT
Fundamento. La hipertensión arterial (HTA) es uno de los principales motivos de consulta de los centros de atención primaria (AP). El objetivo del estudio fue determinar la asociación entre el grado de control de la HTA, la comorbilidad y los costes directos en atención primaria. Métodos. Diseño retrospectivo-multicéntrico. Se incluyó a sujetos mayores de 30 años pertenecientes a cinco equipos de AP (año 2006). Criterios: buen control (<140/90, y <130/80 mmHg en personas diabéticas y presencia de enfermedad cardiovascular [ECV]). Principales medidas: generales, ECV, índice de Charlson, casuística/comorbilidad (Adjusted Clinical Groups), parámetros clínicos y costes directos (fijos/semifijos y variables [medicamentos, pruebas y derivaciones]). Análisis de regresión logística y de ANCOVA para la corrección del modelo, p<0,05. Resultados. La prevalencia de HTA fue del 26,5% (edad media: 67,1 años; varones: 43,5%). El buen control fue del 52,0% (IC: 51,2-52,8%). El mal control tuvo una relación independiente con la diabetes (OR=3,8), el ECV (OR=2,2) y los varones (OR=1,2), p<0,001. El promedio/unitario/año del coste directo corregido fue de 1.202,13 vs. 1.183,55 (p=0,032). Conclusiones. Los pacientes en situación de mal control muestran una mayor carga de morbilidad y un similar coste sanitario (AU)
Background. Arterial hypertension is one of the main reasons for primary care consultations. This study is aimed at determining the relationship among the degree to which arterial hypertension is controlled, comorbidity and the direct costs in primary care. Methods. Retrospective, multi-centre design. Subjects over 30 years of age pertaining to five primary care teams (2006) were included. Criteria: good control (<140/90 and <130/80 mmHg in diabetics and those with cardiovascular disease [CVD]. Main general measurements, CVD, Charlson index, casuistic/comorbidity (Adjusted Clinical Groups), clinical parameters and direct costs (fixed/semifixed and variable costs) [medications, tests and referrals]) Logic regression and ANCOVA for correcting the model, p<0.05. Results: The prevalence of arterial hypertension was 26.5% (mean age: 67.1 years; males: 43.5%). Good control totalled 52.0% (CI: 51.2-52.8%). Poor control was independently related to diabetes (Odds Ratio=3.8), CVD (Odds Ratio=2.2) and males (Odds Ratio=1.2), p<0.001. The average/direct unit cost/year was 1,202.13 vs. 1,183.55 (p=0.032). Conclusions. Those individuals whose arterial hypertension was poorly controlled displayed a greater burden of morbidity and a similar healthcare cost in comparison to those under good control (AU)
