Potentially avoidable hospitalizations for hypertension in Switzerland

Abstract We assessed the trends, characteristics. and consequences of potentially avoidable hospitalizations (PAH) for hypertension in Switzerland, for period 1998 to 2018. Hospital discharge data from the Swiss federal office of statistics. Hospitalizations with hypertension as the main cause for admission were eligible. PAH for hypertension was defined according to the Organization for Economic Cooperation and Development criteria. Overall, data from 117’507 hospitalizations (62.1% women) was used. The number of PAH increased between 1998 (n=1685) and 2018 (n=3410), and their frequency among hospitalizations for hypertension increased from 36.9% in 2008 to 73.0% in 2018. Compared to non-PAH, patients with PAH for hypertension were younger, more frequently women (66.9% vs. 56.7%), non-Swiss nationals (15.9% vs. 10.9%), were more frequently admitted as an emergency (78.9% vs. 59.5%), and by the patient’s initiative (33.1% vs. 14.1%). Patients with PAH had also less comorbidities, as per the Charlson’s index. Patients with PAH for hypertension were more frequently hospitalized in a semi-private or private setting, stayed less frequently in the ICU (4.6% vs. 7.3%), were discharged more frequently home (91.4% vs. 73.0%), and had a shorter LOS than patients with non-PAH for hypertension: median and interquartile range 5 3-8 vs. 9 4-15 days. In 2018, the total costs of PAH were estimated at 16.5 million CHF, corresponding to a median cost of 4936 (4445-4961] CHF per stay. We conclude that in Switzerland, PAH represent a considerable fraction of hospitalizations for hypertension, and carry a non-negligible health cost.