Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-03 Cooperative journals: 《中国全科医学》
Abstract：
Background Hypertension as a risk factor can significantly increase the morbidity and mortality of cardiovascular and cerebrovascular diseases, and effective control of hypertension is the key to prevent and treat cardiovascular diseases. Objective Collect literature on the evaluation of the effectiveness of hypertension management models in China. Evaluate the management effects of different models and provide a reference for further optimization of hypertension management models. Methods Using StataSE-64, a network meta-analysis of the 18 included hypertension management model papers was performed using blood pressure control rates as an evaluation metric. The models included five models: joint hospital-community management, community management, hospital treatment management, general management, and combined Internet management. Results Joint hospital-community management, community management, hospital management, and combined Internet management are all effective for hypertension control. The order is joint hospital-community management ≈ combined Internet management > hospital treatment management > community management > blank control. Among them, the joint hospital-community management model has significant effect on hypertension control; the joint hospital-community management model and combined Internet management has similar effect; and hospital management has better effect than community management. Conclusion In order to improve the hypertension management model, the construction of hospital-community-family management model in primary health care institutions should be promoted, and the combination of chronic disease management model and combined Internet model should be guided to strengthen the whole-life, whole-cycle management of chronic disease patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-03 Cooperative journals: 《中国全科医学》
Abstract：
Background Hypertension is the most common chronic non-communicable disease affecting the health of the people in China. As an important point for hypertension management and control, the management ability of primary care directly affects the management effect. The current status and common rules of hypertension management in primary care in China need to be further explored. Objective To understand the current status of hypertension management in primary care in China, summarize the typical experience, and provide suggestions for the optimization of hypertension management in China. Methods From November to December 2021, semi-structured interviews were conducted with 29 hypertension management stakeholders in five provinces in China. Guided by the World Health Organization's health system, the interviews were analyzed from six dimensions: leadership and governance, service delivery, health workforce, financing, access to essential medicine, and health information system. Results For leadership and governance, hypertension management at primary level mainly relied on contracted family doctor service and multi-department collaboration. In terms of service provision, general practice and specialty integration services should be provided to meet the individual medical needs of patients. For health workforce, community general practitioners are the main force of hypertension management in primary care, and their work enthusiasm is improved by performance appraisal and distribution according to their work. For financing, hypertensive patients can obtain preferential policy support of medical insurance reimbursement at primary care. For accessibility, basic medical equipment and essential hypertension drugs were equipped at primary level. For health information system, the regional medical and health information platform can realize health information sharing and service coordination of contracted patients. Conclusions Primary health care institutions are responsible for the long-term follow-up and management of hypertension patients. It is necessary to further enhance the capacity of primary health care comprehensive management and primary health service supply, strengthen the capacity building of primary health care personnel, improve the reimbursement and payment system of medical insurance, and improve the drug and equipment conditions for hypertension treatment in primary care. It can effectively empower primary hypertension management and further improve the level of primary hypertension management.
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