The economic burden of hypertension in rural south-west China

Objective To estimate the economic burden of hypertension in a given year in rural Yunnan Province of China, including direct, indirect and intangible costs. Methods A prevalence-based cost-of-illness method was used to estimate the economic burden of hypertension. Data on participants demographic characteristics, inpatient hospitalisation expenditures, outpatient visit expenditures, self-medication costs and indirect costs related to hypertension were collected from a cross-sectional health examination and questionnaire survey, involving 9396 consenting individuals aged =18 years and 3500 households. Blood pressure (BP) levels were determined from the average of three BP measurements. Years of life lost (YLL) because of hypertension was estimated using medical death certificates. Results The overall prevalence of and YLL/1000 population because of hypertension was 24.8% and 1.5 years for the survey population, respectively. Mean unit direct medical costs, direct non-medical costs, morbidity costs, mortality costs, intangible costs and cost of illness were estimated to be $467.2, $20.1, $23.5, $8265.1, $417.4 and $9393.3, respectively. The total cost of hypertension was estimated to be $231.7 million. Direct costs represented the largest component of economic cost of hypertension. On average, males had higher overall direct, indirect and intangible costs of hypertension than females. Both indirect and intangible costs decreased with age, whereas direct costs increased with age. The incidence of household catastrophic health payment and household impoverishment because of hypertension was 8.9% and 4.1%, respectively. Conclusions Hypertension inflicts a considerable economic burden upon individual households and society as a whole in Yunnan Province, China.