The Early Impact of the People-centred Integrated Care on the Hypertension Management in Shenzhen

Feiyan Liu; Fangchao Liu; Jinchun Lin; Jian Wang; Jichun Chen; Jianxin Li; Jianfeng Huang; Dongsheng Hu; Xiangfeng Lu; Xizhuo Sun; Dongfeng Gu

doi:10.5334/ijic.6539

The Early Impact of the People-centred Integrated Care on the Hypertension Management in Shenzhen

Int J Integr Care. 2023 Feb 6;23(1):6. doi: 10.5334/ijic.6539. eCollection 2023 Jan-Mar.

Authors

Feiyan Liu^{1

2}, Fangchao Liu³, Jinchun Lin⁴, Jian Wang⁴, Jichun Chen³, Jianxin Li³, Jianfeng Huang³, Dongsheng Hu⁵, Xiangfeng Lu³, Xizhuo Sun⁴, Dongfeng Gu^{1

2

3

6}

Affiliations

¹ Department of Epidemiology and Biostatistics, Centre for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
² Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine, Southern University of Science and Technology, Shenzhen, China.
³ Department of Epidemiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴ Shenzhen Luohu Hospital Group, Shenzhen, China.
⁵ Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, China.
⁶ School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China.

Abstract

Objective: To evaluate the impact of the integrated care in Luohu, China on the hypertension management.

Methods: Hypertensive patients aged 35-74 years were recruited by the cluster-randomized sampling method from Luohu district which adopted integrated care and another district that remained original routine care during October 2018~January 2020, with 1353 and 583 patients from integrated and routine care communities, respectively. Health information, knowledge, attitude, and practice (KAP) towards cardiovascular diseases, pharmaceutical expenditure on hypertension and its comorbidities, and healthcare-related satisfaction were collected by questionnaires, with the expenditure additionally verified by hospitals' billing records database. Continuous and categorical variables were compared by Wilcoxon test and Chi-square test, respectively. The age-standardized hypertension control rate was calculated by direct standardization.

Results: The standardized hypertension management rate in the integrated care communities (45.75%) was significantly higher than that in routine care communities (14.07%) (P < 0.0001), while the age-standardized hypertension control rates were similar (integrated care: 50.3%, routine care: 52.65%, P = 0.518). The pharmaceutical expenditure on hypertension and its comorbidities in the integrated care communities was Ұ264.23 ± 357.38/month/person, lower than that in the routine care communities (Ұ354.56 ± 430.59/month/person). Patients in the integrated care had higher KAP scores (73.48 ± 11.54), compared with routine care (68.89 ± 15.51) (P < 0.0001). Moreover, the integrated care communities had higher satisfaction rates towards the convenience of dual referral (90.15% vs. 77.99%) and service quality (95.18% vs. 87.81%) than routine care communities (P < 0.0001).

Conclusion: The practice of the integrated care in Luohu has substantially improved the hypertension management and the healthcare-related satisfaction while with relatively low pharmaceutical expenditure. The investigation of long-term impact of the integrated care on hypertension control and management is warranted.

Keywords: KAP; Luohu model; hypertension management; people-centred integrated care; pharmaceutical expenditure; satisfaction.

Grants and funding

This study was supported by Sanming Project of Medicine in Shenzhen (No. SZSM201601069) and the Shenzhen Science and Technology Innovation Committee (No. ZDSYS20200810171403013).