Family physician services and blood pressure control in China: A population-based retrospective cohort study.

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES Journal of Health Services Research & Policy Pub Date : 2023-07-01 DOI:10.1177/13558196221149929
Rize Jing, Karen Eggleston, Xiaozhen Lai, Hai Fang
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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.
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中国家庭医生服务和血压控制:一项基于人群的回顾性队列研究
目的:鉴于持续家庭医生护理在高血压管理中的重要性,我们探讨了这种护理在中国高血压患者中的效果,中国高血压患者的这种护理通常没有得到充分利用。我们研究了计划生育服务的使用和连续性与健康结果(包括血压控制率、收缩压和舒张压)之间的纵向关联。方法:我们使用来自中国厦门市回顾性区域电子健康记录数据库的数据进行了一项基于人群的队列研究。该研究纳入了18119名18岁以上的高血压患者,这些患者在过去12个月内至少去过两次健康中心。采用广义估计方程模型估计计划生育服务利用与健康结果的纵向关联。结果:与没有FP或有FP但由普通社区医生(GCP)治疗的高血压患者相比,自行FP治疗的高血压患者血压控制率(OR = 1.14, 95% CI: 1.02 ~ 1.28)更高,舒张压(-0.36 mmHg, 95% CI: -0.52 ~ -0.20)更低。与只接受gcp治疗的高血压患者相比,持续和只接受FP治疗的患者血压得到控制的可能性高出45% (OR = 1.45, 95% CI: 1.32-1.60),收缩压和舒张压分别降低0.6 mmHg (95% CI: -0.78至-0.39)和0.6 mmHg (95% CI: -0.79至-0.47)。结论:持续自行治疗的高血压患者在血压控制率、收缩压和舒张压值方面表现较好。此外,FP访问的次数和连续性与更好的血压控制有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
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.
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