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

Abstract

BackgroundHypertension 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.MethodsData 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.ResultSome 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.ConclusionsHypertension management strategies should further focus on the frequency of healthcare follow-up management via 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.

Dawning public health services dogma: An indigenous Southwest Chinese perspective in managing hypertension-with or without the “BPHS”?

“…It may be related to the fact that the BPHS system in Yunnan Province has linked multiple medical electronic databases, benefiting from the management of more patients. Such patients receiving more BPHS accessible health education services, a better awareness of their health, and improved medication adherence, similar to the study in Zhejiang Province and Jiangsu Province in China (25,47). Moreover, 17.3% of the BPHS patients used a combination of antihypertension drugs (vs. non-BPHS 8.6%), which has facilitated blood pressure control to normal in patients in the BPHS group.…”

“…With BPHS, 35.1% of hypertensive patients have received four or more follow-up assessments in the past 1 year ( 19 ), uncontrolled hypertension was reduced by 26% ( 20 ). However, most of the earlier studies on being covered by BPHS were self-reported by participants, and focused on the rate of service delivery from primary doctors ( 21 , 22 ), patient service satisfaction ( 23 , 24 ) and the community health management rate of hypertensive patients ( 25 , 26 ). Previous studies also showed a low prevalence of combination therapy and limited compliance with hypertension drug treatment ( 27 , 28 ).…”

The Role of Noncommunicable Disease Clinics in Improving Control of Hypertension and Diabetes Among Adults Residing in Rural Ballabgarh, Haryana

“…Adequate follow-up was significantly associated with control status among adults with hypertension, with an odds ratio of 2.34. Peng et al [ 21 ] conducted a study among the Chinese population and reported similar results. Regular follow-up will not only increase awareness but also increase adherence and compliance to medication among adults [ 22 - 24 ].…”

The impact of hypertension follow-up management on the choices of signing up family doctor contract services: does socioeconomic status matter?

“…Studies have shown that hypertension can be prevented and improved through effective management [ 17 ]. Follow-up visits of hypertension are regular clinic activities for hypertensive patients to achieve blood pressure control, emphasized by a series of hypertension guidelines [ 18 ]. Regular follow-up visits of hypertension could enhance blood pressure monitoring and improve medication adherence, thereby preventing complications and reducing medical expenses [ 19 ].…”

“…Actually, patients with hypertension may be diagnosed and initially followed up in large hospitals and clinics, considered to be "passive" health management for disease causes [ 21 ]. Further, a high frequency of follow-up services improved the health level and health awareness of hypertensive patients leading residents proactively to seek health management and sign with family doctors [ 22 , 23 ]. Primary health workers have also contributed greatly to increasing family doctor contracting rates for patients with hypertension follow-up management [ 13 , 24 ].…”