Abstract
Background: Hypertension requires long-term treatment and medication, which not only affects people’s health, but also brings heavy economic burden for families and society. Therefore, it is meaningful to reveal the actual personal and socio-economic burdens of hypertension based on a tool recognized internationally to improve management of hypertensive patients and provide more information for policy makers, analysts, and international comparisons. Methods: We collected expense records of 180441 hypertensive outpatients and 14763 inpatients in Shanxi Province of China in 2017. Curative care expenditure for hypertension(CCEht) were analyzed based on System of Health Accounts 2011, and influencing factors were analyzed by multiple layer perceptron (MLP) neural network.Results: In 2017, CCEht was US$ 307.71 million, accounted for 3.63% of the total CCE and 0.14% of GDP in Shanxi Province of China. CCE of hypertensive outpatients (CCEht-out) and inpatients (CCEht-in) accounted for 44.49% and 55.51% of the CCEht, drug fee accounted for 81.55% of CCEht-out and 22.50% of CCEht-in, respectively. CCEht increased from the age of 30, and the highest occured in age 60-69. The patients with the age of 40-79 accounted for 86.49% of total CCEht. CCEht of male patients were generally higher than that of female, and there is a significant difference between CCEht for male and female in terms of age. The diagnosis and treatment capacity of primary health care system had been enhanced. New rural cooperation medical insurance and urban employee basic medical insurance had the trend of overusing, and burden of family healthcare expenditure was still very heavy. In the MLP neural network, the top three influencing factors were drug fee, surgical fee and hospitalization days for inpatients, drug fee, examination fee and test fee for outpatients. Conclusions: To ease the economic burden of hypertensive patients and improve the utilization efficiency of social resources , the policy makers should pay more attention to the hypertensive patients aging 40-79, strengthen prevention and outpatient treatment for young men and the inpatient treatment for women at older ages, further increase support for primary health care system, standardize the treatment and reimbursement of hypertension, and incline the reimbursement policy to outpatient service.