Rize Jing, Karen Eggleston, Xiaozhen Lai, Hai Fang
{"title":"Family physician services and blood pressure control in China: A population-based retrospective cohort study.","authors":"Rize Jing, Karen Eggleston, Xiaozhen Lai, Hai Fang","doi":"10.1177/13558196221149929","DOIUrl":null,"url":null,"abstract":"Objective Given the importance of continuous family physician (FP) care in the management of hypertension, we explored the effects of such care among hypertensive patients in China, a country where such care is generally underutilized. We examined the longitudinal association between the use and continuity of FP services and health outcomes including blood pressure (BP) control rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Methods We conducted a population-based cohort study using data from the retrospective regional electronic health record database in Xiamen City, China. The study considered 18,119 hypertensive patients aged over 18 years who had at least two visits to a health center in the preceding 12 months. The generalized estimating equation model was adopted to estimate the longitudinal association between FP service utilization and health outcomes. Results Hypertensive patients treated by their own FPs had a higher BP control rate (OR = 1.14, 95% CI: 1.02–1.28) and lower DBP (−0.36 mmHg, 95% CI: −0.52 to −0.20) than those without a FP or those with a FP but treated by a general community physician (GCP). Compared with hypertensive patients treated exclusively by GCPs, patients treated continuously and exclusively by a FP were 45% more likely to have their BP under control (OR = 1.45, 95% CI: 1.32–1.60), and their SBP and DBP were lower by 0.6 mmHg (95% CI: −0.78 to −0.39) and 0.6 mmHg (95% CI: −0.79 to −0.47), respectively. Conclusions Hypertensive patients continuously treated by their own FPs performed better in terms of BP control rate, SBP and DBP values. In addition, the number and continuity of FP visits were associated with better BP control.","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Health Services Research & Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/13558196221149929","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective Given the importance of continuous family physician (FP) care in the management of hypertension, we explored the effects of such care among hypertensive patients in China, a country where such care is generally underutilized. We examined the longitudinal association between the use and continuity of FP services and health outcomes including blood pressure (BP) control rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Methods We conducted a population-based cohort study using data from the retrospective regional electronic health record database in Xiamen City, China. The study considered 18,119 hypertensive patients aged over 18 years who had at least two visits to a health center in the preceding 12 months. The generalized estimating equation model was adopted to estimate the longitudinal association between FP service utilization and health outcomes. Results Hypertensive patients treated by their own FPs had a higher BP control rate (OR = 1.14, 95% CI: 1.02–1.28) and lower DBP (−0.36 mmHg, 95% CI: −0.52 to −0.20) than those without a FP or those with a FP but treated by a general community physician (GCP). Compared with hypertensive patients treated exclusively by GCPs, patients treated continuously and exclusively by a FP were 45% more likely to have their BP under control (OR = 1.45, 95% CI: 1.32–1.60), and their SBP and DBP were lower by 0.6 mmHg (95% CI: −0.78 to −0.39) and 0.6 mmHg (95% CI: −0.79 to −0.47), respectively. Conclusions Hypertensive patients continuously treated by their own FPs performed better in terms of BP control rate, SBP and DBP values. In addition, the number and continuity of FP visits were associated with better BP control.
期刊介绍:
Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.