Financing medical services in children with arterial hypertension within public health insurance

Abstract

Background. Arterial hypertension in children and teenagers is more often perceived as an interdisciplinary problem. The subject literature most often presents reports concerning medical issues. Very rare are reports presenting the problem from the perspective of public health and economy.

Aim. The aim of the study was to analyse the burden imposed on public health insurance system by providing services due to hypertension in children and teenagers in Silesian Province.

Material and methods. In this paper, the data from the Database of Healthcare Services of the Silesian Regional Branch of National Healthcare Fund in 2013 and 2014 and MZ-11 reports were used.

Results. In Silesian Province, in primary healthcare units in 2013 hypertension was diagnosed in 19,317 patients aged 0–18 years, while in 2014 — in 18,173 patients. In 2013 the cost of services provided within specialist outpatient care due to hypertension amounted to 116,853 PLN (for 787 patients), while in 2014 — 130,384 PLN (for 804 patients). In the years 2013–2014 in clinical centres, 480 hospitalizations for 372 patents with hypertension were registered, while in the other hospital healthcare centres — 391. The value of services provided in hospital setting was 1,383,923 PLN in 2013 and 1,357,332 PLN in 2014. Essential hypertension (I10 according to ICD) in different clinical units was diagnosed in 86.33–88.29% of the hospitalized patients due to hypertension, while in other hospitals — in 93.86% of patients with hypertension.

Conclusions

1. Hospitalizations due to hypertension in patients aged 0–18 years generate the biggest financial burden for the payer for services.
2. Nearly half of hospitalizations were provided in academic centres.
3. The most numerous group of the hospitalized individuals were patients at the age of 15–18 who were diagnosed with essential hypertension.
4. The scope of services provided during hospitalization in clinical centre departments and regional hospitals significantly differs.