TY - JOUR
T1 - Healthcare resource utilisation and costs associated with hypertension in children and adolescents
T2 - a population-based cohort study
AU - Hussain, Junayd
AU - Ahmed, Rabeeyah
AU - Robinson, Cal H.
AU - Jeyakumar, Nivethika
AU - Smith, Graham
AU - Brady, Tammy M.
AU - Dart, Allison B.
AU - Dionne, Janis
AU - Karam, Sabine
AU - McKay, Ashlene
AU - Parekh, Rulan S.
AU - Sinha, Manish D.
AU - South, Andrew M.
AU - Vincent, Carol
AU - Chanchlani, Rahul
N1 - Publisher Copyright:
© 2025
PY - 2025/8
Y1 - 2025/8
N2 - Background: The global prevalence of paediatric hypertension has increased, contributing to long-term cardiovascular and kidney morbidity. However, healthcare resource utilisation and costs attributable to paediatric hypertension remain uncertain. This study evaluates healthcare utilisation and costs among hypertensive children compared to controls. Methods: In a population-based retrospective cohort study, we analysed youth (aged 3–18 years) diagnosed with hypertension in Ontario, Canada (1993–2021). Using propensity score matching, 25,605 hypertensive children were compared to 128,025 controls and followed until death, emigration, or 31 March 2022. Healthcare utilisation (hospitalisations, emergency visits, outpatient visits) was assessed via negative binomial regression. Secondary outcomes included healthcare costs and specialist follow-up. Findings: Median age was 15 years [IQR 11–17], 49% were female, and comorbidities were uncommon (4% (6497/153,630) congenital heart disease, 2% (9359/153,630) malignancy, 2% (2892/153,630) diabetes, 1% (2004/153,630) chronic kidney disease). Over a median follow-up of 12.9 [IQR 6.8–19.9] years, hypertensive children had higher hospitalisations (rate ratio [RR] 2.13, 95% CI 2.03–2.22), emergency visits (RR 1.08, 95% CI 1.05–1.11), and outpatient visits (RR 1.33, 95% CI 1.31–1.34). Mean healthcare costs were substantially higher in children with hypertension, especially in the first year ($16,690 vs $2659 per person-year). Interpretation: Healthcare resource utilisation was significantly higher in youth with hypertension. These findings provide a basis for future cost-effectiveness studies on preventing paediatric hypertension and its complications. Funding: This study was funded in part by a 2021/2022 CoRE Builder Team Grant from McMaster University's Department of Paediatrics and supported by ICES Western, funded by the Ontario Ministry of Health (MOH) and Ministry of Long-Term Care.
AB - Background: The global prevalence of paediatric hypertension has increased, contributing to long-term cardiovascular and kidney morbidity. However, healthcare resource utilisation and costs attributable to paediatric hypertension remain uncertain. This study evaluates healthcare utilisation and costs among hypertensive children compared to controls. Methods: In a population-based retrospective cohort study, we analysed youth (aged 3–18 years) diagnosed with hypertension in Ontario, Canada (1993–2021). Using propensity score matching, 25,605 hypertensive children were compared to 128,025 controls and followed until death, emigration, or 31 March 2022. Healthcare utilisation (hospitalisations, emergency visits, outpatient visits) was assessed via negative binomial regression. Secondary outcomes included healthcare costs and specialist follow-up. Findings: Median age was 15 years [IQR 11–17], 49% were female, and comorbidities were uncommon (4% (6497/153,630) congenital heart disease, 2% (9359/153,630) malignancy, 2% (2892/153,630) diabetes, 1% (2004/153,630) chronic kidney disease). Over a median follow-up of 12.9 [IQR 6.8–19.9] years, hypertensive children had higher hospitalisations (rate ratio [RR] 2.13, 95% CI 2.03–2.22), emergency visits (RR 1.08, 95% CI 1.05–1.11), and outpatient visits (RR 1.33, 95% CI 1.31–1.34). Mean healthcare costs were substantially higher in children with hypertension, especially in the first year ($16,690 vs $2659 per person-year). Interpretation: Healthcare resource utilisation was significantly higher in youth with hypertension. These findings provide a basis for future cost-effectiveness studies on preventing paediatric hypertension and its complications. Funding: This study was funded in part by a 2021/2022 CoRE Builder Team Grant from McMaster University's Department of Paediatrics and supported by ICES Western, funded by the Ontario Ministry of Health (MOH) and Ministry of Long-Term Care.
KW - Healthcare resources
KW - Healthcare utilization
KW - Hospitalizations
KW - Long-term outcomes
KW - Outpatient care
KW - Pediatric hypertension
KW - Population-based cohort
KW - Preventive medicine
KW - Public health
UR - https://www.scopus.com/pages/publications/105008797047
UR - https://www.scopus.com/pages/publications/105008797047#tab=citedBy
U2 - 10.1016/j.lana.2025.101157
DO - 10.1016/j.lana.2025.101157
M3 - Article
C2 - 40657431
AN - SCOPUS:105008797047
SN - 2667-193X
VL - 48
JO - The Lancet Regional Health - Americas
JF - The Lancet Regional Health - Americas
M1 - 101157
ER -
