Abstract 241: Burden of hypertension on hospitals in USA: Analysis of Nationwide Emergency Department Sample Data
Introduction: Cardiovascular diseases are a leading cause of morbidity and mortality in USA. Hypertension (HTN) is a major risk factors for cardiovascular disease with unclear extent of burden on USA healthcare. This study was done to identify the burden imposed by HTN independently on hospitals in USA.
Methods: We used Nationwide Emergency Department (ED) Sample data to extract data for patients who visited ED with first listed diagnosis of HTN. Clinical classification software code 98 and 99 were used to identify patients with essential HTN and HTN with complications and secondary HTN respectively. Data was extracted for the years 2006 to 2011.
Results: We identified a total of 3,938,456 ED visits with first listed diagnosis of essential HTN for years 2006-11 with admission rate of 9.76% (384,495 out of 3,938,456). The rate of ED visits increased from 190.1 visits per 100,000 persons in 2006 to 238.5 visits per 100,000 persons in 2011 (p<0.01). However, the admission rates decreased significantly from 10.47% (59,374 out of 567,232) in 2006 to 8.85% (65,729 out of 742,997) in 2011 (p<0.01).
We identified 1,429,308 ED visits with first listed diagnosis of HTN with complication and secondary HTN for years 2006-11 with admission rate of 73.41% (1,049,199 out of 1,429,308). The rate of patient visits to ED increased from 71.2 per 100,000 persons in 2006 to 84.7 per 100,000 persons in 2011 (p<0.01), however the admission rate decreased significantly from 77.79% (165,254 out of 212,440) in 2006 to 68.75% (181,527 out of 264,050) in 2011 (p<0.01). The in-hospital mortality for admitted patients decreased from 1.95% in 2006 to 1.25% in 2011 (p<0.05).
Conclusions: Our study revealed that number of patients visiting ED with first listed diagnosis of essential HTN and HTN with complication and secondary HTN increased steadily from 2006 to 2011. Though admission rate for patients visiting ED decreased, the aggregate number of admitted patients increased leading to increased burden on both ED and in-patient healthcare facility indicating still large unmet need for better outpatient care to prevent these ED visits and hospitalizations. The decreasing in-hospital mortality rate points to improving care of hospitalized patients.
Author Disclosures: S. Aggarwal: None. Y. Agrawal: None. V. Gupta: None.
- © 2014 by American Heart Association, Inc.