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中国高血压患者的随访管理服务和健康结局:来自江苏省国家卫生服务调查的横断面分析。

Follow-up management service and health outcomes of hypertensive patients in China: A cross-sectional analysis from the national health service survey in Jiangsu province.

机构信息

School of Health Policy Management, Nanjing Medical University, Nanjing, China.

The Public Health Policy and Management Innovation Research Team, Nanjing Medical University, Nanjing, China.

出版信息

Front Public Health. 2022 Jul 26;10:956711. doi: 10.3389/fpubh.2022.956711. eCollection 2022.

Abstract

BACKGROUND

Hypertension is a major cause of early mortality worldwide. Health follow-up management services can encourage patients with hypertension to improve their health behavior and outcomes. However, a lack of studies on the relationship between specific factors of follow-up management and both subjective and objective health outcome among hypertensive patients exists. The current study investigated the relationship between service content, frequency, mode, and institutions of follow-up management and health outcomes among Chinese hypertensives.

METHODS

Data were obtained from the sixth National Health Service Survey (NHSS) of Jiangsu Province, which was conducted in 2018. Descriptive statistics were used to analyze the sample characteristics and the utilization of follow-up management services. Both multiple linear regression and logistic regression were used to estimate the association of follow-up management service and other factors with hypertensives' subjective and objective health outcomes.

RESULT

Some respondents (19.30%) reported hypertension, and 75.36% of these patients obtained follow-up management services. Hypertensive patients' subjective health outcome self-reported health status and objective health outcome blood pressure (BP) control were found to be significantly associated with follow-up management services. The outcomes were both significantly improved by a high frequency of management services, a high level of follow-up providers, the mode of visiting healthcare facilities and/or calling, and receiving instructions on medication use. However, inquiring about patients' symptoms was negatively associated with self-reported health status and BP control. In addition, BP measurement was significantly and positively associated with hypertensive patients' self-reported health status; the patients receiving lifestyle guidance were more likely to have their BP levels under control.

CONCLUSIONS

Hypertension management strategies should further focus on the frequency of healthcare follow-up management categorization of the follow-up services and appropriate adjustment of service delivery modes to optimize health follow-up management for hypertensives further improve their outcomes. Meanwhile, complementary policies are also needed to address other socioeconomic factors that can promote good health conditions for hypertension patients.

摘要

背景

高血压是全球范围内导致早逝的主要原因之一。健康随访管理服务可以鼓励高血压患者改善其健康行为和结果。然而,目前缺乏研究关注随访管理的具体因素与高血压患者主观和客观健康结果之间的关系。本研究调查了中国高血压患者随访管理服务的内容、频率、方式和机构与健康结果之间的关系。

方法

数据来自 2018 年进行的江苏省第六次国家卫生服务调查(NHSS)。描述性统计用于分析样本特征和随访管理服务的利用情况。采用多元线性回归和逻辑回归来估计随访管理服务以及其他因素与高血压患者主观和客观健康结果的关系。

结果

一些受访者(19.30%)报告患有高血压,其中 75.36%的患者接受了随访管理服务。高血压患者的主观健康结果(自我报告的健康状况)和客观健康结果(血压(BP)控制)与随访管理服务显著相关。管理服务频率高、随访提供者水平高、就诊和电话随访方式以及接受用药指导都显著改善了这两个结果。然而,询问患者症状与自我报告的健康状况和 BP 控制呈负相关。此外,BP 测量与高血压患者的自我报告健康状况显著正相关;接受生活方式指导的患者更有可能控制其血压水平。

结论

高血压管理策略应进一步关注医疗保健随访管理的频率、随访服务的分类以及适当调整服务提供模式,以优化高血压患者的健康随访管理,进一步改善其结果。同时,还需要制定补充政策,解决其他促进高血压患者良好健康状况的社会经济因素。

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