Table 2:
Medical Care Costs for Patients with >1 Hypertensive BP
| TeenBP CDS (n=488) | Usual Care (n=437) | |||||
|---|---|---|---|---|---|---|
| Mean | Change from baseline | Mean | Change from baseline | Study arm differential Change from baseline, Mean (95% CI) | P-Value | |
| Clinic-based Costs | ||||||
| 12 months, pre-index | 472 | 383 | ||||
| 12 months, post-index | 777 | 305 | 662 | 279 | 27 (−78 to 131) | 0.618 |
| Primary Care Visit Costs | ||||||
| 12 months, pre-index | 227 | 201 | ||||
| 12 months, post-index | 402 | 175 | 393 | 192 | −17 (−57 to 23) | 0.407 |
| Urgent Care Visit Costs | ||||||
| 12 months, pre-index | 34 | 35 | ||||
| 12 months, post-index | 37 | 3 | 37 | 2 | 1 (−13 to 14) | 0.942 |
| Cardiology and Nephrology Specialty Care Visit Costs | ||||||
| 12 months, pre-index | 8 | 5 | ||||
| 12 months, post-index | 39 | 31 | 10 | 26 (−4 to 55) | 0.090 | |
| Laboratory Costs | ||||||
| 12 months, pre-index | 105 | 80 | ||||
| 12 months, post-index | 156 | 52 | 136 | 56 | −5 (−55 to 45) | 0.853 |
| Laboratory Costs, BP-related | ||||||
| 12 months, pre-index | 13 | 9 | ||||
| 12 months, post-index | 21 | 8 | 18 | 9 | −1 (−6 to 4) | 0.742 |
| Laboratory Costs, CV-related | ||||||
| 12 months, pre-index | 15 | 10 | ||||
| 12 months, post-index | 26 | 11 | 22 | 12 | −1 (−7 to 5) | 0.704 |
| Radiology Costs | ||||||
| 12 months, pre-index | 97 | 58 | ||||
| 12 months, post-index | 150 | 53 | 87 | 29 | 24 (−32 to 79) | 0.402 |
| Pharmacy Costs | ||||||
| 12 months, pre-index | 247 | 267 | ||||
| 12 months, post-index | 302 | 55 | 321 | 54 | 1 (−47 to 49) | 0.967 |
| Pharmacy Costs, HTN-related | ||||||
| 12 months, pre-index | 3 | 0 | ||||
| 12 months, post-index | 2 | −1 | 1 | 1 | −1 (−3 to 1) | 0.262 |
| Overall Costs | ||||||
| 12 months, pre-index | 712 | 657 | ||||
| 12 months, post-index | 1,069 | 357 | 993 | 336 | 22 (−97 to 140) | 0.723 |
Notes: BP = blood pressure; CI = confidence interval; CV = cardiovascular; HTN = hypertension. Costs presented in this table were measured in the 12 months before and after the first date patients met study criteria with at least one hypertensive BP measurement (≥95th percentile, based on age, sex, and height). Clinic-based costs comprise of the sum of primary care visit, urgent care visit, cardiology and nephrology specialty care visit, laboratory, and radiology costs. Overall costs comprise of the sum of clinic-based and pharmacy costs. Codes for identifying costs in each category are described in Appendix Table 1. Mean and incremental changes in costs were estimated using a generalized estimating equation model with a time x study arm interaction term and covariate adjustment for age, race, and insurance status at baseline. The 95% confidence intervals account for patient random effects and were estimated using a Huber/White robust sandwich estimator. All costs are in 2015 U.S. dollars.