| Title | Effects and cost-effectiveness of a guideline-oriented primary healthcare hypertension management program in Beijing, China: results from a 1-year controlled trial |
| Authors | Wang, Xin Li, Weiqin Li, Xian An, Ning Chen, Hao Jan, Stephen Ming, Guanghua Hua, Qi Yan, Xiaowei Sun, Ningling Zhao, Dong Wu, Yangfeng |
| Affiliation | Chinese Acad Med Sci, Fuwai Hosp, Beijing 100730, Peoples R China. Tianjin Womens & Childrens Hlth Ctr, Tianjin, Peoples R China. George Inst Global Hlth, Beijing, Peoples R China. Beijing Hosp, Beijing, Peoples R China. George Inst Global Hlth, Sydney, NSW, Australia. Beijing Union Med Coll Hosp, Beijing, Peoples R China. Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China. Capital Univ Med Sci, Beijing An Zhen Hosp, Beijing, Peoples R China. Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing 100871, Peoples R China. Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, 38 Xueyuan Rd, Beijing 100191, Peoples R China. |
| Keywords | cost-effectiveness evaluation guideline intervention CONTINUING MEDICAL-EDUCATION PHYSICIAN PERFORMANCE RANDOMIZED-TRIAL CHRONIC ILLNESS BLOOD-PRESSURE RISK-FACTORS QUALITY DISEASES IMPACT IMPROVE |
| Issue Date | 2013 |
| Publisher | hypertension research |
| Citation | HYPERTENSION RESEARCH.2013,36,(4),313-321. |
| Abstract | Hypertension control rates are unacceptably low in China. The present study demonstrates if a customized, guideline-oriented training program can cost-effectively improve hypertension management in primary healthcare. Four typical community health centers in Beijing were selected and randomized to intervention or control (one urban and one rural each). A sample of 140 patients with hypertension and blood pressure uncontrolled was recruited from each center. Primary healthcare providers in intervention centers provided management to the recruited patients for 1 year after receiving training with customized hypertension management guidelines, and primary healthcare providers in control provided with usual care. Intention-to-treat analysis showed that hypertension control (systolic blood pressure (SBP) <140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg)) rate was significantly higher in interventions than controls at month 3 (42.1% vs. 34.3% in urban and 30.7% vs. 10.0% in rural centers) and the trend increased to month 12 (70.7% vs. 40.0% in urban and 72.9% vs. 27.9% in rural); P-values by logistic mixed model were all <0.001 for both urban and rural after adjustment for baseline multiple variables including blood pressure. Mean reductions of SBP and DBP were significantly larger in interventions. The intervention was cost-saving, with an average incremental cost-saving of US$ 20.3 per patient in urban sites and $ 7.0 per patient in rural sites. Corresponding results from per-protocol analysis were very similar. The customized, guideline-oriented hypertension management program in primary healthcare in China effectively improved blood pressure control and was cost-saving. Hypertension Research (2013) 36, 313-321; doi: 10.1038/hr.2012.173; published online 15 November 2012 |
| URI | http://hdl.handle.net/20.500.11897/391875 |
| ISSN | 0916-9636 |
| DOI | 10.1038/hr.2012.173 |
| Indexed | SCI(E) |
| Appears in Collections: | 人民医院 公共卫生学院 |
