Study On Economic Burden And Life Lost Of Hypertension In Shanghai

Hypertension is a common cardiovascular and cerebrovascular disease which is characterized by the continuous increase of blood pressure of arteries. And hypertension plays a major etiologic role in the development of cerebrovascular disease, ischemic heart disease, cardiac and renal failure and leads serious complications.Because of the increasing prevalence of contributing factors such as obesity, insufficient exercise and unhealthy diet, hypertension is becoming an increasing common health problem worldwide. According to Kearney's study from the published literature, the prevalence of adults with hypertension in 2025 was predicted to increase from 26.4% to 29.2%. Until 2003, hypertension has caused 7.1 million premature deaths and 4.5% of the disease burden (6.4 million DALYs) throughout the world.Shanghai is one of the metropolises in the world. The economic status and life expectancy of people here have approached the level of the developed countries. At present, hypertension is prevalent in Shanghai. Reported from risk factors surveillance in 2007, the average systolic blood pressure of adults (age35-70) was 129.3mmHg, and diastolic blood pressure was 81.3mmHg, which was higher than the national level and met the threshold of "prehypertension".This study is conducted to give an overview of economic burden and life lost contributed to hypertension in Shanghai, and to discuss the development of health policies for prevention and control of this condition. Investigation was conducted to get data as well as healthcare setting and survey system. Epidemiology and the global burden of disease method were combined to conduct the study. The objectives of this study were (1) to estimate the total and per capital economic burden of hypertension and its complications in Shanghai in the year 2008; (2) to discuss the healthcare utilization of hypertension; (3) to calculate the total and per capital years of life lost due to hypertension from 2006 to 2008. The results of the present studies are showed as follow:1. Totally,753 patients were investigated. The average age was 63.4. Their average hypertension period was 9.9 years and average annual income was 12,680.50 Yuan.98.8% of the patients were covered by social insurances.48.3% of the patients are with normal blood level. And 9.6% of the patients had complications of hypertension2. Two-week Hospital Visit Rate was 21.0% and yearly hospitalization rate was 3.2%. More than 80% patients went to the primary health facilities, which inflected the trend that more and more chronic illness should be treated at the community health facilities. The factors influencing the healthcare utilization of hypertension were living place and health insurance.3. The economic burden of hypertension and its complications in Shanghai in the year 2008 was 1.58 billion Yuan, which accounted for 1.2‰of GDP and 3.3% of total health expenditure. And 1.2 billion Yuan was attributed to direct medical cost. The economic burden of hypertension was 632 Yuan per capita per year. Among them, expenditure for outpatient was 132 Yuan, for purchase of medicines was 19 Yuan, and for hospitalization was 321 Yuan.The cost was significantly higher in patients with complications than without complications. The per-time outpatient expenditure among patients from different district, with different social insurance, different course of disease and different blood pressure control as well as patients with different household per capital income differs significantly.4. In the past 3 (2006-2008) years, the mortality rate and the ratio of death numbers by total deaths were stable. In 2008, the mortality rate was around 11.0 per 100 thousand in 2008, increasing with age. And it was higher in women than men. 80% of total deaths incurred by hypertension at age over 70 years old. The index of premature deaths decreased with year in both male and female, which indicated that the numbers of emerging patients were substantial.Our findings suggests that the burden of hypertension in shanghai is not severe. But with the aging process, unhealthy lifestyle and changing disease model, hypertension is still an important public-health challenge. Prevention, detection, treatment, and control of this condition should receive high priority. Hypertension is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Arid we should strengthen health invest and medical insurance on patients in rural area. In addition, it is necessary to make full use of community health services for building up sustainable management model.