Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia

Abstract

Hypertensive patients need long-term therapy and control. Uncontrolled blood pressure can aggravate the incidence of hypertension and develop into a more dangerous disease that can have an impact on quality of life and medical costs. The study aimed to analyze the differences in clinical outcomes on quality of life and direct medical costs. The method employed was a cross-sectional study with 400 outpatient hypertensive patients in August 2023 at Panembahan Senopati Regional Hospital, Special Region of Yogyakarta, Indonesia. Data were collected by filling out questionnaires and observing medical and financial record data. Demographic data were analyzed descriptively and showed that the majority of female patients (65%), aged 46 - 65 years (51%) possessed a high school education (30%). Sixty-six percent of patients had hypertension with a duration of <5 years and 61% had comorbidities. This study attempted to measure the clinical outcomes on quality of life and direct medical costs of hypertensive patients. The EuroQol-5 Dimension (EQ-5D-5L) and Visual Analogue Scale (VAS) questionnaires were used to measure patients' quality of life. The data on direct medical costs included medications, laboratories, medical equipment, and administrative costs. Clinical outcome indicators were blood pressure measurements. The results showed that 316 of 400 patients showed uncontrolled clinical outcomes (79%) with an average score for a good quality of life based on the quality of life assessment with EQ5D5L and VAS and incurred direct medical costs of Indonesian Rupiah (IDR) 663,80. Based on the VAS measurement, there was a significant difference in quality of life between patients with controlled and uncontrolled clinical outcomes (p<0.001). Patients with controlled clinical outcomes had higher quality of life and incurred lower costs. Altogether, controlling hypertension in all patients with or without complications can be practical and cost-effective.