Date of Award

Spring 5-5-2020

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Ike Okosun MS, MPH, PhD, FTOS, FACE

Second Advisor

Dr. Iris A. Castro-Revoredo MD, MPH



Although the prevalence, treatment, and control of hypertension are well documented in the US, the medical annual costs of visits associated with controlled hypertension in local institutions and factors affecting the medical costs are not well studied. This study is designed to analyze the annual cost of visits for controlled hypertension treatment in the Primary Care Center at Grady Hospital in 2016-2017.


Data (2016-17) were obtained from a retrospective chart review of all subjects with hypertension and diabetics using randomly selected providers in the Primary Care Center at Grady Hospital. Controlled hypertension was defined as all patients with blood pressure <140/90mmhg. Costs of visits were obtained from the. Medicare fee schedule (2016), and published literature. Univariate and multivariate regression analyses were used to determine the odds of spending more on hypertension visits. In the multivariate analyses, adjustments were made for age, sex, ethnicity, other comorbidities, acute issue, and having diabetics.


Seven hundred and twenty-five subjects from a sample of 835 were found to have controlled hypertension. Total per-person annual costs of treatment associated with controlled hypertension ranged from $ 102.98 to $411.92 in 2016-2017. Age of the participants, other comorbidities, more than one acute issue and, having diabetes were found to be the reasons for variation in annual costs of visits for hypertensive patients. Controlling for other clinical and demographic characteristics, patient’s annual cost of visits differs among provider’s level of training(p=0.001).


Variations in annual costs of visits among several groups of hypertensive patients have been observed. Expansion of preventive services for other health issues that are associated with hypertension may be an effective way to alleviate the economic burden from the individual and national level.

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