Impact of the National Essential Public Health Services Policy on Hypertension Control in China

Zhang, Donglan; Xi, Peng; Li, Shukai; Liang, Dan; Hou, Zhiyuan; Li, Yan; Shi, Lu

doi:10.1093/ajh/hpx139

Cited by 45 publications

(71 citation statements)

References 27 publications

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“…An average of ¥15 was allotted per capita in 2009 and was increased to ¥55 in 2018. Following the previous literature, findings of the studies showed the following: the coverage of BPHS has increased greatly, but it has not reached the goal of universal coverage,22 23 especially coverage of migrants24 25; the utilisation of the BPHS is generally improved, but some of the services are underutilised26 27; ensuring equal access to the basic public health services is improved,28 29 and the gaps between urban–rural areas and different regions have been narrowed, but inequality still exists24 30 31; and with respect to the effects of the BPHS policy, there are some improvements in maternal health services and reductions in maternal mortality,32 and improved the treatment and control among patients with hypertension and type 2 diabetes 33 34. New evidence from the Global Burden of Disease Study showed that China has made substantial progress in reducing the burden of many diseases and disabilities 35…”

Section: Coverage Of Health Servicesmentioning

confidence: 99%

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

et al. 2020

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Universal health coverage (UHC) has been identified as a priority for the global health agenda. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. We conducted a secondary data analysis and combined it with a literature review, analysing the overview of UHC in China with regard to financial protection, coverage of health services and the reported coverage of the WHO and the World Bank UHC indicators. The results include the following: out-of-pocket expenditures as a percentage of current health expenditures in China have dropped dramatically from 60.13% in 2000 to 35.91% in 2016; the health insurance coverage of the total population jumped from 22.1% in 2003 to 95.1% in 2013; the average life expectancy increased from 72.0 to 76.4, maternal mortality dropped from 59 to 29 per 100 000 live births, the under-5 mortality rate dropped from 36.8 to 9.3 per 1000 live births, and neonatal mortality dropped from 21.4 to 4.7 per 1000 live births between 2000 and 2017; and so on. Our findings show that while China appears to be well on the path to UHC, there are identifiable gaps in service quality and a requirement for ongoing strengthening of financial protections. Some of the key challenges remain to be faced, such as the fragmented and inequitable health delivery system, and the increasing demand for high-quality and value-based service delivery. Given that China has committed to achieving UHC and ‘Healthy China 2030’, the evidence from this study can be suggestive of furthering on in the UHC journey and taking the policy steps necessary to secure change.

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Section: Coverage Of Health Servicesmentioning

confidence: 99%

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

et al. 2020

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“…In 2009, the Chinese government implemented the Essential Public Health Services (EPHS), a national health service program promoting the management of NCDS represented by hypertension and diabetes in primary care [5]. The hypertension service for EPHS focuses on follow-up and management for hypertension patients and developing primary prevention of related education on knowledge and behavior for all residents [6]. …”

Section: Introductionmentioning

confidence: 99%

Changes in Hypertension-Related Knowledge and Behavior and Their Associations with Socioeconomic Status among Recently Urbanized Residents in China: 2013–2016

Zhang

Meng

Luo

et al. 2018

IJERPH

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The rapid urbanization in China has brought with it some health benefits, but it also brought about a negative influence on the lifestyle of residents. We conducted this study to assess the change in hypertension-related knowledge and behavior from 2013 to 2016 among recently urbanized residents and determine their association with socioeconomic status (SES). This research used data from two cross-sectional studies conducted in Hezuo community in Chengdu, Sichuan province of China. A total of 2268 and 2601 individuals, respectively, participated and completed standard questionnaires. According to the results, the median (IQR) scores of health knowledge was 1 (0,3) and 3 (1,5), respectively, (p < 0.001) and the median (IQR) scores of health behavior was 6 (5,6) and 5 (5,6), respectively, (p < 0.001) in 2013 and 2016. The rate of sufficient knowledge increased from 8.8% to 18.1% (p < 0.001), while the rate of correct behavior decreased from 54.5% to 45.5% (p < 0.001) in three years. Logistic regression analysis showed that higher education was associated with sufficient hypertension-related knowledge (p < 0.05), and those with higher education, unemployment, and retirement were more likely to have sufficient behavior (p < 0.05). The impact of SES on knowledge was stable between 2013 and 2016. The behavior difference between the middle school educated and the illiterate increased from 2013 to 2016 (p < 0.05), and the behavior difference between the unemployed and manual workers decreased from 2013 to 2016 (p < 0.05). Our results revealed that hypertension-related knowledge improved with no corresponding improvement in self-reported behavior among recently urbanized residents from 2013 to 2016. Organizational strategy should be implemented to improve health education on knowledge, and what is more, translate knowledge into behavior. All these measures should be given more attention to the lower educated and manual workers among recently urbanized residents to eliminate the SES disparity.

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“…For example, based on the situation in Sichuan, improvements of the following five aspects may be effective. Firstly, we can rely on National Essential Public Health Services (EPHS), which can improve the treatment and control on patients, as well as basic healthcare services to every citizen [43,44].…”

Section: Discussionmentioning

confidence: 99%

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

et al. 2020

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Background: Hypertension is highly prevalent and is the primary risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). While declining in some developed countries, it is increasing rapidly in some developing countries. Sichuan province is the largest and underdeveloped region in southwest China, with 486 thousand square kilometers, more than 80 million residents, unbalanced economic development, and high prevalence, low awareness, low treatment and low control rate of hypertension. We forecasted the death burden due to high systolic blood pressure (SBP) in Sichuan from 1990 to 2030, to raise the awareness of public and government of the importance and benefits of hypertension control. Methods: We conducted secondary analysis based on data of Global Burden of Disease (GBD) 1990-2015, and predicted the population SBP level, population attributable fraction, and death burden for people aged 30-69 under different scenarios in 2030. Results: Comparing with natural trend, if the prevalence of high SBP can be reduced relatively by 25% by 2030, the deaths of non-communicable chronic diseases (NCDs), CVD and CKD would be reduced by 27.1 thousand, 26.2 thousand and 0.8 thousand for people aged 30-69; the mortality would be reduced by 10.8, 32.8 and 16.0%; and the premature mortality would be reduced by 9.9, 32.0 and 16.0%, respectively. Conclusions: Controlling or decreasing the prevalence of high SBP can significantly reduce the deaths, death rate and premature mortality of NCDs, CVD and CKD for the 30-69 years old population in Sichuan. There would be huge benefits for the governments to take cost-effective measures to control or reduce the prevalence of hypertension.

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Impact of the National Essential Public Health Services Policy on Hypertension Control in China

Abstract: The National EPHS program improved the treatment and control among hypertension patients. Expanding its program reach could further benefit the cardiovascular health of the population.

Cited by 45 publications

References 27 publications

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

Changes in Hypertension-Related Knowledge and Behavior and Their Associations with Socioeconomic Status among Recently Urbanized Residents in China: 2013–2016

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

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