Kết quả tối ưu hóa chi phí trong quản lý tăng huyết áp ngoại trú: Bằng chứng từ thực hành tuyến cơ sở

Abstract

This retrospective pre–post study of 140 patients with hypertension at District 3 Medical Center evaluated changes in treatment costs before and after an outpatient management optimization intervention. Cost data were extracted from medical records and health insurance claims and analyzed using a Gamma-distributed Generalized Estimating Equations model in R version 4.5.0. Following the intervention, median total direct medical costs decreased from 538,680 (348,110 – 721,197) VND to 209,176 (166,224 – 421,332) VND, and median cost per treatment day declined from 17,958 (11,623 – 24,471) VND to 6,973 (5,541 – 14,044) VND (p < 0.001). Health insurance expenditures decreased substantially, whereas patient out-of-pocket payments did not change significantly. The GEE model indicated that post-intervention costs were 45 percent lower compared with pre-intervention levels; higher body mass index and alcohol consumption were associated with increased costs. These findings provide real-world evidence supporting cost management strategies for hypertension in primary care settings.