Kamath Rajesh, Brand Helmut, Ravandhur Arun Harshith, Lakshmi Vani, Sharma Nishu, D'souza Reshma Maria Cocess
Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Department of International Health, Care and Public Health Research Institute-CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands.
Healthcare (Basel). 2023 Jun 2;11(11):1630. doi: 10.3390/healthcare11111630.
The present study explores district-level data associated with health insurance coverage (%) and the prevalence of hypertension (mildly, moderately, and severely elevated) observed across men and women as per NFHS 5. Coastal districts in the peninsular region of India and districts in parts of northeastern India have the highest prevalence of elevated blood pressure. Jammu and Kashmir, parts of Gujarat and parts of Rajasthan have a lower prevalence of elevated blood pressure. Intrastate heterogeneity in spatial patterns of elevated blood pressure is mainly seen in central India. The highest burden of elevated blood pressure is in the state of Kerala. Rajasthan is among the states with higher health insurance coverage and a lower prevalence of elevated blood pressure. There is a relatively low positive relationship between health insurance coverage and the prevalence of elevated blood pressure. Health insurance in India generally covers the cost of inpatient care to the exclusion of outpatient care. This might mean that health insurance has limited impact in improving the diagnosis of hypertension. Access to public health centers raises the probability of adults with hypertension receiving treatment with antihypertensives. Access to public health centers has been seen to be especially significant at the poorer end of the economic spectrum. The health and wellness center initiative under Ayushman Bharat will play a crucial role in hypertension control in India.
本研究探讨了与医疗保险覆盖率（%）以及根据国家家庭健康调查（NFHS）-5观察到的男性和女性高血压患病率（轻度、中度和重度升高）相关的地区层面数据。印度半岛地区的沿海地区以及印度东北部部分地区的高血压患病率最高。查谟和克什米尔、古吉拉特邦部分地区以及拉贾斯坦邦部分地区的高血压患病率较低。血压升高空间模式的邦内异质性主要出现在印度中部。高血压负担最重的是喀拉拉邦。拉贾斯坦邦是医疗保险覆盖率较高且高血压患病率较低的邦之一。医疗保险覆盖率与高血压患病率之间存在相对较低的正相关关系。印度的医疗保险通常涵盖住院护理费用，不包括门诊护理费用。这可能意味着医疗保险在改善高血压诊断方面的影响有限。利用公共卫生中心会增加高血压成年人接受抗高血压药物治疗的可能性。在经济状况较差较差较差谱的较贫困端，利用公共卫生中心尤为重要。阿育吠陀健康保险（Ayushman Bharat）下的健康与 wellness 中心倡议将在印度的高血压控制中发挥关键作用。
