Analysis Of The Control Rate And Impact Factors Of Hypertension In Outpatient Department In Hospitals Of Different Grades In Chongqing

Objective:To explore the control rate and impact factors ofhypertension in outpatient department in hospitals of different grades inChongqing.Methods:A Total number of2742patients who were diagnosed asHypertension in five tertiary hospitals、six secondary hospitals、fiveprimary hospitals where been choosed by the method of stratified clustersampling at Yuzhong district、Nanan district、Banan district、Jiulongpodistrict、Dadukou district、Shapingba district、Fuling district、Wanzhoudistrict、Changshou district、Kaixian County、Miao-Tujia AutonomousCounty of Pengshui、Wuxi County of Chongqing were interviewed withquestionnaire.Qualified personnel who were received training measuredblood pressure and surveyed questionnaire and writed the questionnaireuniformly.Investigation process was been controled strictly.Results： The total control rate of hypertensive outpatients inChongqing was46.0%.The control rates of the primary，secondary andtertiary hospitals were38.7%，46.7%，51.1%，there is significant differenceamong them(χ~2=28.787，P=0.000)，there is significant difference of controlrate between the primary hospitals（38.7%）and the secondary hospitals （46.7%）（χ~2=11.407，P=0.001），the primary hospitals（38.7%）and thetertiary hospitals（51.1%）（χ~2=28.500，P=0.000）.The total complicationrates of hypertensive outpatient in the primary，secondary and tertiaryhospitals were35.0%，48.8%，65.8%，there is significant difference amongthem(χ~2=175.402，P=0.000)，there is significant difference of complicationrates between the primary hospitals（35.0%）and the secondary hospitals（48.8%）（χ~2=33.677，P=0.001），the primary hospitals（35.0%）and thetertiary hospitals（65.8%（χ~2=173.065，P=0.000），the secondary hospitals（48.8%） and the tertiary hospitals（65.8%）（χ~2=56.618，P=0.000）.Theaverage courses of disease of hypertensive outpatients in the primary，secondary and tertiary hospitals were4.0±4.0years、7.0±10.0years、8.0±12.0years， there is significant difference among them(H=171.835，P=0.000)，and there is significant difference between the primary hospitals（4.0±4.0years）and the secondary hospital（s7.0±10.0years）（H=11.970，P=0.001），the primary hospitals（4.0±4.0years）and the tertiary hospitals（8.0±12.0years）（H=144.971，P=0.000）.The blood pressure control rateof the group of illiteracy was33.4%，the group of primary culture was43.8%，the group of junior high school culture was45.8%，the group ofsenior high school culture was52.0%，the group of junior college cultureand abov was53.2%， there is significant difference amongthem(χ~2=34.581，P=0.000)，and there is significant difference of bloodpressure control rates between the group of illiteracy（33.4%）and the groupof primary culture （43.8%）(χ~2=9.526，P=0.002)，the group of illiteracy（33.4%）and the group of junior high school culture（45.8%）(χ~2=13.533，P=0.000)，the group of illiteracy（33.4%）and the group of senior high school culture（52.0%）(χ~2=26.690，P=0.000)， the group of illiteracy（33.4%）and the group of junior college culture and above（53.2%）(χ~2=23.580，P=0.000)，the group of primary culture（43.8%）and the groupof senior high school culture（52.0%）(χ~2=8.920，P=0.003)，the group ofprimary culture （43.8%）and the group of junior college culture and above（53.2%）(χ~2=7.791， P=0.005).The blood pressure control rates ofhypertensive outpatients who joined the social security、the new ruralcooperative medical system (NCMS)、the other insurance were51.4%，37.9%，40.2%，there is significant difference among them(χ~2=46.655，P=0.000)，and there is significant difference of blood pressure control ratesbetween the social security（51.4%）and the new rural cooperative medicalsystem（37.9%）(χ~2=44.264，P=0.000)，the social security（51.4%）andthe other insurance（40.2%）(χ~2=7.583，P=0.006). The blood pressurecontrol rates of retirees、peasants、other careers were52.3%，35.9%，47.0%，there are significant difference among them(χ~2=56.410，P=0.000)，and there is significant difference of blood pressure control rates betweenpeasants（35.9%）and retirees（52.3%）(χ~2=56.126，P=0.000)，peasants（35.9%）and other career（s47.0%）(χ~2=17.878，P=0.000). The control ratesof hypertensive outpatients who measured blood pressure frequently，whenfeeling uncomfortable，rarely were52.5%，43.6%，39.7%，there aresignificant difference among them(χ~2=36.181，P=0.000)，and there issignificant difference of blood pressure control rates between theoutpatients who measured blood pressure frequently （52.5%） and theoutpatients who measured blood pressure when feeling uncomfortable（43.6%）(χ~2=13.281，P=0.000)，the outpatients who measured blood pressure frequently （52.5%） and the outpatients who measured bloodpressure rarely（39.7%）(χ~2=34.248，P=0.000). The blood pressure controlrates of the normal BMI，overweight，obesity were49.1%，43.9%，40.4%，there are significant difference among them(χ~2=11.539，P=0.003)，and thereis significant difference of blood pressure control rates between the normalBM（I49.1%）and the overweigh（t43.9%）(χ~2=6.626，P=0.010)，the normalBMI（49.1%） and the obesity（40.4%）(χ~2=8.430，P=0.004). The bloodpressure control rates of the normal waist circumference and the abdominalobesity were49.3%and43.5%，there is significant difference of bloodpressure control rates between them(χ~2=8.892，P=0.003).The results ofMulti-factor logistic regression analysis showed that the factor ofincreasing blood pressure control rate were treating in high gradehospitals、measureing blood pressure frequently、losing weight.Conclusion:1.The control rates of hypertensive outpatient inChongqing in the primary hospital was lowest，the tertiary hospital washighest；the total complication rates increased from the primary hospital tothe tertiary hospital；the average course of disease in the primary hospitalwas lowest，the tertiary hospital was highest.2.The factors which influencedthe blood pressure control rate of hypertensive outpatient in Chongqingwere the standard of culture、the medical insurance、the career and thefrequency of measuring blood pressure.3.The BMI and the WC impactedthe blood pressure control rate.