Health care utilisation and out-of-pocket expenditure associated with hypertension: an analysis of Australian adults from the 45 and Up Study

Hypertension is a common condition worldwide that significantly increases morbidity and mortality rates in the older population. A number of treatment options are available to control blood pressure. The purpose of this study was to assess the use of health services and self-care amongst people with hypertension and to estimate the out-of-pocket expenses associated with such health care use. A sub-study of the 45 and Up Study was conducted amongst 1300 individuals who had earlier reported a clinical diagnosis of hypertension in 2017. A total of 753 (57.9%) individuals with hypertension returned a completed questionnaire. In the last 12 month, for their hypertension management, 84% of participants consulted a doctor, 19% of them consulted an allied health practitioner and 9% of them consulted a complementary medicine practitioner. The average total out-of-pocket expenditure for hypertension-related health care was Australian $461.8 per annum, with an estimated Australian $941 million per annum if extrapolated to all Australians aged 55 years and over with hypertension. Older people with hypertension use a wide range of health services to control their blood pressure including conventional medicine, allied health and complementary medicine practitioners as well as various self-care practices. A substantial amount of out-of-pocket expenditure has been spent on hypertension care annually. Given the global health and economic burden of hypertension, there is an urgent need for more research exploring cost-effective management(s) for hypertensive patients.