Key result
The average output of hypertension management in Chinese primary care facilities increased by 492.83%, from 123.83 to 610.27 per 10,000 population between 2009 and 2017.
Why the study?
Given the high prevalence of hypertension in China, the study aimed to evaluate trends in hypertension management output in primary care facilities and assess the effect of the national basic public health services project from 2009 to 2017.
Observational (n=685)
Yes
Effect estimate: 492.83% growth
Absolute Event Rate: 610.27% vs 123.83%
Hypertension management output in Chinese primary care facilities increased rapidly from 2009 to 2012 but slowed thereafter, remaining low compared to overall prevalence.
Trends in Chinese primary care hypertension management may vary by facility factors; leaves open national project effects on delivery.
BACKGROUND: The prevalence of hypertension is high (25.2% in 2012) and there were a large number of patients with hypertension (more than 200 million) in China. Township health centres in rural areas and community health centres in urban areas are responsible for hypertension management. This study aims to identify trends in hypertension management output and related facility-level, geographical and economic factors in primary care facilities and to assess the effect of the national project of basic public health services in China from 2009 to 2017. METHODS: A cross-sectional survey (2018) was combined with retrospective data collection (2009-2017) from 685 primary care facilities in six provinces in China. The hypertension management output was indicated by the number of patients with hypertension under management per 10,000 population. Latent class growth analysis and group-based trajectory models were applied to classify trajectories and determine associations with facility-level, geographic and economic characteristics. RESULTS: The trend in the output increased rapidly from 2009 to 2012 with an average growth rate of 54.58% and slowed down from 2012 to 2017 (growth rate of 5.94%). Five trajectories of the output were identified and labelled according to baseline status and increase rates: low-gradually increasing (16.9%), middle-slightly increasing (16.2%), low-sharply increasing (7.9%), middle-sharply increasing (34.2%) and persistently high (24.9%). The time-stable characteristics, including region (eastern, central or western), district (urban or rural), landform, were associated with hypertension management output of the facilities. Number of public health physicians was a significant time-dependent characteristic influencing management output. CONCLUSIONS: Five latent trajectories of hypertension management output were identified. The output was still at a low level compared with the prevalence of hypertension. Hypertension screening in young people need to be emphasized. Facilities are recommended to establish good relationships with residents for better hypertension management outcomes especially in urban areas.
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Duan et al. (2023) conducted an observational in Hypertension (n=685). National basic public health services project implementation vs. Baseline (2009) was evaluated on Average output of hypertension management (patients managed per 10,000 population) (492.83% growth). The average output of hypertension management in Chinese primary care facilities increased by 492.83%, from 123.83 to 610.27 per 10,000 population between 2009 and 2017.
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