Buffel Veerle, Bos Philippe, Chham Savina, Chimm Srean, Danhieux Katrien, Ku Grace Marie, Van Olmen Josefien, Zavrnik Crt, Klemenc-Ketis Zalika, Wouters Edwin
Department of Sociology, Brussels Institute of Social and Population Studies (BRISPO), Interface Demography (ID), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Department of Sociology, Centre for Population, Family and Health, University of Antwerp, Antwerp, Belgium.
Int J Integr Care. 2025 Aug 22;25(3):22. doi: 10.5334/ijic.8921. eCollection 2025 Jul-Sep.
We built Cascades of Care (CoC) for hypertension in Belgium, Slovenia and Cambodia, and assessed CoC stratifications across patients' gender and socioeconomic status. Differences between the CoCs were studied by looking at the level of implementation of the integrated care package and other health system characteristics.
A mixed methods design: Age-standardized gender-specific hypertension cascades were built from survey and register data and logistic regression analyses were performed. Focus group discussions with experts were used to interpret these results.
In Belgium, the largest gap is between 'prevalence' and 'diagnosis'. In Cambodia, a large drop -especially among men- is found at the beginning and the end of the cascade. In Slovenia, only a limited number of patients is tested and linked to care, but once registered, attrition is quite low. Poor financial situation was a significant determinant of drop-out across the countries but at different stages of the CoC, and especially in Cambodia large gender differences were observed with women being better retained throughout the CoC.
Despite contextual differences between the countries and difficulties in comparability of the cascades, lessons can be learnt from each country's strengths and weaknesses to improve quality of integrated hypertension care.
我们在比利时、斯洛文尼亚和柬埔寨建立了高血压护理级联体系（CoC），并评估了不同性别和社会经济状况患者的CoC分层情况。通过考察综合护理包的实施水平及其他卫生系统特征，研究了各国CoC之间的差异。
采用混合方法设计：利用调查和登记数据构建年龄标准化的特定性别高血压护理级联体系，并进行逻辑回归分析。通过与专家进行焦点小组讨论来解读这些结果。
在比利时，“患病率”与“诊断率”之间的差距最大。在柬埔寨，护理级联体系的起始阶段和末尾阶段出现了大幅下降，尤其是在男性中。在斯洛文尼亚，只有有限数量的患者接受检测并获得护理服务，但一旦登记，失访率相当低。经济状况不佳是各国患者退出护理级联体系的一个重要决定因素，但在CoC的不同阶段情况各异，特别是在柬埔寨，观察到了显著的性别差异，女性在整个CoC过程中的留存率更高。
尽管各国情况不同，护理级联体系的可比性存在困难，但可以从每个国家的优势和劣势中吸取经验教训，以提高高血压综合护理的质量。
