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学科主题: 临床医学
题名:
Effects and cost-effectiveness of a guideline-oriented primary healthcare hypertension management program in Beijing, China: results from a 1-year controlled trial
作者: Wang, Xin1; Li, Weiqin2; Li, Xian3; An, Ning1; Chen, Hao4; Jan, Stephen5; Ming, Guanghua1; Hua, Qi1; Yan, Xiaowei6; Sun, Ningling7; Zhao, Dong8; Wu, Yangfeng3,9
关键词: cost-effectiveness ; evaluation ; guideline ; intervention
刊名: HYPERTENSION RESEARCH
发表日期: 2013-04-01
DOI: 10.1038/hr.2012.173
卷: 36, 期:4, 页:313-321
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Peripheral Vascular Disease
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: CONTINUING MEDICAL-EDUCATION ; PHYSICIAN PERFORMANCE ; RANDOMIZED-TRIAL ; CHRONIC ILLNESS ; BLOOD-PRESSURE ; RISK-FACTORS ; QUALITY ; DISEASES ; IMPACT ; IMPROVE
英文摘要:

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

语种: 英语
WOS记录号: WOS:000317105700006
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54229
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.George Inst Global Hlth, Sydney, NSW, Australia
2.Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China
3.Tianjin Womens & Childrens Hlth Ctr, Tianjin, Peoples R China
4.George Inst Global Hlth, Beijing, Peoples R China
5.Beijing Hosp, Beijing, Peoples R China
6.Chinese Acad Med Sci, Fuwai Hosp, Beijing 100730, Peoples R China
7.Beijing Union Med Coll Hosp, Beijing, Peoples R China
8.Capital Univ Med Sci, Beijing An Zhen Hosp, Beijing, Peoples R China
9.Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing 100871, Peoples R China

Recommended Citation:
Wang, Xin,Li, Weiqin,Li, Xian,et al. Effects and cost-effectiveness of a guideline-oriented primary healthcare hypertension management program in Beijing, China: results from a 1-year controlled trial[J]. HYPERTENSION RESEARCH,2013,36(4):313-321.
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