Effectiveness Prediction of Community-based Hypertension Management in China:an Analysis based on Risk Prediction Models
1.Division of Community Health,China National Health Development Research Center,Beijing 100191,China
2.Victoria Institute of Strategic Economics Studies,Victoria University,Melbourne 3000,Australia
3.Department of General Practice,Shanghai East Hospital,Tongji University,Shanghai 200120,China
*Corresponding author:LIU Fang,Associate research fellow;E-mail:liuf@nhei.cn
Abstract:Objective To analyze the effectiveness of community-based hypertension management after 2009 under the investment of the public health service equalization(PHSE) program in China.Methods The data stemmed from the China Health and Nutrition Survey(1991,1993,1997,2000,2004,2006,2009,2011).A sample of 10 242 participated,and 9 553 who positively responded to the survey were included in the final analysis,including 1 025 with a confirmed diagnosis of hypertension 〔1 007 of whom aged 35-84(317 were under control but other 690 were not) 〕.Trend and isometric analyses were performed to predict the effectiveness of community-based hypertension management in 2013.The risk for 10-year risk of cardiovascular and cerebrovascular diseases and ratio of people with this kind of risk were calculated,so that,long-term(10-year) effectiveness of hypertension management in China was analyzed.Results In 2013,after the social,economic factors and health services developing factors were adjusted,the predicted number of people with awareness of hypertension,people receiving antihypertensive treatment,and those with controlled hypertension was 39 132 883,32 610 735 and28 697 447,respectively.The weighted 10-year risk of fatal and non-fatal cardiovascular and cerebrovascular diseases for people with controlled hypertension and those with uncontrolled hypertension was 6.34%,16.34%,respectively,indicating that this risk in those with controlled hypertension was lowered by 10 percentage points by hypertension control interventions.The predicted number of people with cardiovascular and cerebrovascular diseases developed from controlled and uncontrolled hypertension in 10 years was 1 819 275,4 689 995,respectively,showing that the cases of such diseases among those with controlled hypertension were decreased by 2 870 720 by hypertension control interventions.Conclusion The PHSE program contributed to the improvement of hypertension awareness,treatment and control in China.It lowered hypertensive population's 10-year risk of developing into fatal or non-fatal cardiovascular and cerebrovascular diseases.Further emphasis needs to be focused on comprehensive interventions for chronic disease patients.The study improved the evaluation of hypertension intervention in primary care,providing an evidence for long-term economic evaluations of the PHSE program in China.