Huang Kehui, Song Yu Ting, He Yong Huan, Feng Xing Lin
School of Public Health, Peking University, Xueyuan road 38#, Beijing, 100191 People's Republic of China.
Glob Health Res Policy. 2016 Sep 21;1:13. doi: 10.1186/s41256-016-0013-8. eCollection 2016.
Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic.
A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework.
Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health.
Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts from health system and epidemiological researchers are warranted to extend knowledge in this area.
非传染性疾病是全球疾病负担的主要原因，高血压是最重要的风险因素之一。在过去十年中，中国高血压患病率翻了一番，影响着超过3亿中国人。在本综述中，我们系统地检索了将卫生系统层面因素与中国高血压管理相关联的同行评审出版物，并提供了有关如何改善国家卫生系统以应对高血压流行的现有知识。
制定了一个框架来指导综述。从创刊至2016年4月13日，对PubMed、中国知网数据库进行了系统检索。两名作者独立筛选检索结果以纳入研究，进行数据提取并评估研究质量。根据框架描述主要发现。
共识别出572篇出版物，根据纳入和排除标准，最终保留11篇文章。研究时间段为2010年至2015年。所有11项研究均将卫生系统因素与高血压管理结果相关联。且结果仅聚焦于高血压的知晓率、治疗率和控制率，而非高血压发病率。一项研究是关于卫生系统治理的作用，调查不同组织形式的社区卫生服务中心的绩效；三项研究是关于卫生筹资，比较保险覆盖范围的差异；三项研究是关于卫生信息，实施中国或世界卫生组织的高血压指南，其余三项是关于卫生服务提供机制。未发现有关卫生物力资源和卫生人力资源的研究。
中国高血压患病率一直在迅速上升，中国的高血压管理是一个检测问题而非治疗问题。有限的证据表明卫生系统因素对高血压管理有积极作用，卫生系统和流行病学研究人员有必要共同努力，以扩展该领域的知识。
