Abstract 15914: Sex Differences in Poverty, Health Care Utilization, and Health Care Costs Among Hypertensive Individuals in Western Kenya: LARK Hypertension Study
Introduction: Hypertension is the leading risk factor for global mortality and exerts a substantial economic burden in addition to health burden. As part of the LARK Hypertension Study, individuals from western Kenya with elevated blood pressure were assessed for economic status, health care utilization, and health care costs.
Methods: Individuals with elevated blood pressure formed the LARK cohort. Each participant was administered a questionnaire that assessed income, health care utilization, and health care costs. Differences by sex were evaluated using Fisher exact tests.
Results: Data were available for 819 participants, of whom 55% were women. 21% reported no current employment; women were more likely to be unemployed (Table). Of those working, 60% were farmers, and 18% in business. 60% of working individuals reported monthly earnings < 5000 Kenyan Shillings (approximately US$50); women were more likely to be thus impoverished. Only 17% had any form of health insurance; women were less likely to be insured. In general, women were more engaged in medical care than men. Although the median cost of hypertension- or diabetes-related inpatient admissions was $15, three of the admissions were greater than $150 (more than three times the median monthly income). The majority of outpatient visits were to a rural dispensary (36%), health center (35%), or private clinic (23%), with a median cost of $6/visit. The cost of herbalist visits were $0 for 70% of visits, and only 16% had costs greater than $1. No significant correlations were found between income and hypertension diagnosis or treatment status, overall or by sex.
Conclusions: Poverty is a characteristic feature of hypertensive individuals in this region of western Kenya, with women in particular being vulnerable to high health care costs given higher health care utilization, lower income, and lower health insurance. Hypertension-related inpatient costs can sometimes eclipse monthly incomes and may be catastrophic.
Author Disclosures: R. Vedanthan: None. A. DeLong: None. J.H. Kamano: None. E. Okidi: None. V. Orango: None. J. Rotich: None. K. Asigi: None. C. Chiliswa: None. J. Kisato: None. G.S. Bloomfield: None. J. Hogan: None. C.R. Horowitz: None. T. Inui: None. S. Kimaiyo: None. E. Finkelstein: None. V. Fuster: None.
- © 2016 by American Heart Association, Inc.