THE BLOOD PRESSURE AND THERAPY EXPENDITURE CHANGE DUE TO HYPERTENSION COMORBIDITY: AN ANALYTICAL PROSPECTIVE STUDY IN SECONDARY CARE HOSPITALS IN JOGJAKARTA INDONESIA

  • Rita Suhadi Faculty of Pharmacy, Sanata Dharma University, Yogyakarta-Indonesia
  • Jarir At Thobari Faculty of Medicine, Gadjah Mada University
  • Bambang Irawan Faculty of Medicine, Gadjah Mada University
  • Iwan Dwiprahasto Faculty of Medicine, Gadjah Mada University

Abstract

Objective: To measure the comorbid effect on blood pressure and therapy expenditure in 4 secondary care hospitals in Jogjakarta.

Methods: We conducted an 8-month prospective pharmacoeconomic study with hospital perspective. All hypertensive outpatients, with Askes-insurance whose beneficiaries were governmental employees, with at least 2 moly visits at the index date were included. The subjects with malignancy, hemodialysis, and less than 4 visits were excluded. The expenditure comprised the cost for cardiovascular medicine, doctor, physical/laboratory test, emergency visit, and physiotherapy. We analyzed the expenditure change and sensitivity analysis with Anova-test, whereas the proportion of subjects with good controlled blood pressure with the chi-square test.

Results: The eligible subjects (N=656) consisted of no comorbid (n=105), stroke (n=82), cardiovascular (n=209), diabetes mellitus/chronic kidney disease or DM/CKD (n=149), and combined comorbid (n=111) groups. The baseline blood pressure was similar to no comorbid (p>0.05), except for the diastolic blood pressure in a cardiovascular group. The stroke and cardiovascular groups had more subjects at mean systolic blood pressure lower than 140 mmHg with odds ratio (OR) 2.01 (CI95%:1.12-3.62) and 2.10 (CI95%:1.31-3.39) respectively than no comorbid group; but the mean blood pressure was not clinically different. The total therapy expenditure increased at 6.5% (p<0.61); 22.7% (p<0.03); 78.6% (p<0.01); 78.5% (p<0.01) per subject-visit for stroke, cardiovascular, DM/CKD, and combined-comorbid groups than no comorbid group respectively. Except for stroke group, the incremental expenditure was price-sensitive (p<0.05).

Conclusion: The total therapy expenditure but not blood pressure was likely to be influenced by hypertension comorbidity. We suggest that preventing hypertension comorbidity has the benefit to reduce total therapy expenditure.

Keywords: Hypertension, Comorbidity, Diabetes mellitus, Blood pressure, Stroke, Therapy expenditure

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Suhadi, R., J. A. Thobari, B. Irawan, and I. Dwiprahasto. “THE BLOOD PRESSURE AND THERAPY EXPENDITURE CHANGE DUE TO HYPERTENSION COMORBIDITY: AN ANALYTICAL PROSPECTIVE STUDY IN SECONDARY CARE HOSPITALS IN JOGJAKARTA INDONESIA”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 8, no. 12, Dec. 2016, pp. 78-83, doi:10.22159/ijpps.2016v8i12.14646.
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