The Perception of Health Care Management among Middle-aged and Elderly Patients with Major Cardiovascular Conditions in Rural Settings. (June 2015)

• Record Type: Journal Article
• Authors: Wang, Harry H.X.; Wang, Jia Ji; Li, Jun; Wang, De Liang; Pan, Run Ke; Zhan, Guo Qing; Zhang, Yang Fan; Shen, Geng Xin; Wong, Martin C.S.; Griffiths, Sian M.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 2
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000469789.40081.96
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Background: The population ageing and uneven socio-economic development are common across the globe in China. However, in rural village settings, it is common that health care management are largely overlooked by the attending clinical physicians. Objective: This study assessed the health status and explored the perception of health care management among those with cardiovascular conditions in rural counties in China where the ability to pay is dominant. Method: We performed a cluster random sampling to select patients (aged ≥50 years) at rural health infirmaries in eight villages from three countries in Guangdong province, China. Information on clinical parameters measured on-site and morbidity history from medical records were obtained. The presence of hypertension, diabetes, and dyslipidemia were examined from clinically-diagnosed parameters (including triglycerides, ≥1.69 mmol/L; total cholesterol, ≥5.69 mmol/L; and low-density lipoprotein cholesterol, ≥3.62 mmol/L) according to clinical guidelines. A validated questionnaire to assess the perception of health care management (in a 10-point Likert-type scale) was administered by trained researchers to study subjects. Multiple linear regression analysis was conducted to explore factors associated with the willingness to pay for health care management. Result: The study population (N = 4, 670 out of 4, 800) had an average age of 65.3 years (standard deviation 7.1). Nearly one-third of subjects (31.9%) were illiteracy. The most prevalent condition was hypertension (54.6%), followed by dyslipidemia (43.3%) and diabetes (25.3%). Two-thirds of patients had multiple chronic conditions, with an average score ⩽2 (out of 10) on the perception of health care management. Single-living ( p = 0.018), higher education level ( p = 0.034), and higher income level ( p = 0.001) were independently associated with higher willingness of participating in health care management among the study subjects. Conclusion: The prevalence of cardiovascular conditions was high among middle-aged and older adults in China's rural health infirmary setting. The low-level perception of health care management might be explained by the unaffordablility of patients.