Impact of the National Essential Public Health Services Policy on Hypertension Control in China. (23rd August 2017)

• Record Type: Journal Article
• Authors: Zhang, Donglan; Pan, Xi; Li, Shukai; Liang, Di; Hou, Zhiyuan; Li, Yan; Shi, Lu
• Is Part Of: American journal of hypertension. Volume 31:Number 1(2018:Jan.)
• Page Start: 115
• Page End: 123
• Publication Date: 2017-08-23
• Subjects: access -- blood pressure -- disease control -- effectiveness -- evaluation -- hypertension -- screening -- public policy -- prevention; Hypertension -- Periodicals; 616.132005
• DOI: 10.1093/ajh/hpx139
• Languages: English
• ISSNs: 0895-7061

Abstract

Abstract: BACKGROUND: Hypertension remains a severe challenge to population health worldwide. This study assessed the impact of a nationwide program in China—Essential Public Health Services (EPHS) on improvement of hypertension treatment and control. METHODS: A cohort of hypertensive patients was identified from the 2011–2013 China Health and Retirement Longitudinal Study. Hypertension was defined based on: (i) an average systolic blood pressure of ≥140 mm Hg, and/or an average diastolic blood pressure of ≥90 mm Hg; and/or (ii) currently taking antihypertensive medications. Outcomes assessed included the rate of hypertension control, medication use, and blood pressure monitoring at a doctor's office. The key independent variable was defined as whether one received services from the EPHS-covered physical examination by 2013. Probit regression models with a difference-in-difference approach were performed for each of the 3 outcomes. Data were analyzed in 2017. RESULTS: Among the 4, 958 hypertensive patients, 404 (8.1%) received the EPHS-covered service by 2013. Coverage by the EPHS program was associated with an increase of 7.9% in hypertension control rate (SE = 2.9%, P = 0.020), an increase of 10.3% in the rate of medication use (SE = 2.5%, P < 0.001), and an increase of 10.5% in the rate of blood pressure monitoring (SE = 2.5%, P < 0.001). Results also showed that the EPHS program helped mitigate the geographic disparities in access to health services such as blood pressure monitoring. CONCLUSIONS: 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.