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September 10, 2013Bulletin of the World Health OrganizationOpen Access

Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study

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Key result

Membership in insurance schemes covering outpatient care costs was associated with a higher likelihood of hypertension awareness (aRR 0.737; 95% CI 0.619-0.878), treatment, and control.

Why the study?

Does insurance coverage for outpatient care improve hypertension awareness, treatment, and control in Chinese adults aged ≥45 years?

Population

Chinese people aged 45 years or older from a national survey

Comparison

Membership in insurance schemes covering… vs Other hypertensive individuals without such…

Design

Cross-sectional

Authors

XFXing Lin FengPeking UniversityMPMingfan PangChinese Center For Disease Control and PreventionJBJohn BeardColumbia University

Discussion

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Member takes

Implication

May support expanding outpatient insurance in China to aid hypertension control; leaves open causality from cross-sectional data.

Key Points

  • To assess the prevalence, awareness, treatment, and control of hypertension in China following health system reforms.
  • Used national survey data from 2011-2012 among Chinese individuals aged 45 and older.
  • Detailed anthropometric measurements were included to estimate hypertension prevalence.
  • Modified Poisson regressions were applied to estimate relative risks.
  • Approximately 40% of individuals aged 45 and older had hypertension.
  • Over 40% of hypertensive individuals were unaware of their condition.
  • 80% of those with hypertension were not controlling it effectively.

Study Design

Type

Cross-Sectional

Multicenter

Yes

Structured PICO

Does insurance coverage for outpatient care improve hypertension awareness, treatment, and control in Chinese adults aged ≥45 years?

P
Population
Chinese adults aged 45 years or older assessed for hypertension prevalence, awareness, treatment, and control in a 2011-2012 national survey.
E
Exposure
Membership in insurance schemes covering outpatient care costs
C
Comparator
Other hypertensive individuals without such insurance coverage
O
Outcome
Hypertension prevalence, awareness, treatment, and control

Main Result

Relative Risk: 0.737 (95% CI 0.619–0.878)

A large proportion of hypertension in China remains undetected and untreated, but insurance covering outpatient care significantly improves awareness, treatment, and control.

Cite This Study

Feng et al. (2013) conducted a cross-sectional in Hypertension. Membership in insurance schemes covering outpatient care costs vs. Other hypertensive individuals was evaluated on Awareness of hypertension (aRR 0.737, 95% CI 0.619-0.878). Membership in insurance schemes covering outpatient care costs was associated with a higher likelihood of hypertension awareness (aRR 0.737; 95% CI 0.619-0.878), treatment, and control.

synapsesocial.com/papers/6a55b18b3fdf1787772ac65ahttps://doi.org/10.2471/blt.13.124495

Topics

Hypertension management
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 11999–2009 Trends in Prevalence, Unawareness, Treatment and Control of Hypertension in Geneva, Switzerland2012 · 147 citations
  2. 2Socio‐economic disparities in maternal mortality in China between 1996 and 20062010 · 97 citations
  3. 3Prevalence, Awareness, Treatment, and Control of Hypertension in China2002 · 557 citations