Health Services Use and Expenditures among Middle-Aged and Elderly Residents with Hypertension Comorbidity: A Longitudinal Study in Jiangsu Province, China

Abstract Hypertension is the most prevalent chronic condition in China and is associated with an increased risk of comorbidity. This study aims to investigate health services use and expenditures among community-dwelling residents with hypertension comorbidity. Data is from a 7-month follow-up study of 503 community-dwelling residents aged ≥45 years in Jiangsu Province, China. These participants were stratified into three categories based on their disease status at baseline (no chronic condition, hypertension, hypertension with one or more comorbidities), and followed up monthly to gather information on their health services use and expenditures (including self-medication, outpatient and inpatient services). We used generalized estimating equations to estimate the association between disease status and health services use. 58.1% of individuals with hypertension had a comorbidity. Compared with individuals without any condition, the fully adjusted odds ratio (OR) for those with hypertension comorbidity was 2.18 (95% confidence interval [95% CI] 1.57–3.03) in overall health services use. Rural residents with hypertension comorbidity had a greater odds of health services use compared with their urban counterparts (age and sex-adjusted OR 4.21, 95% CI 2.56–6.93). The median monthly expenditure for individuals with hypertension comorbidity was 172 Chinese Yuan (CNY), which was much higher than those with no condition and those with hypertension only (90 and 91 CNY, respectively). Comorbidity in individuals with hypertension is highly prevalent and associated with elevated health services use and expenditures. These findings emphasize the importance of secondary prevention and integrated care for comorbidity in the population with hypertension.