The Utilization Of Community Health Service(CHS)and Blood Pressure Control In Patients With Hypertension In A Community Of Beijing

Objectives:To investigate the utilization of Community Health Service(CHS)in patients with hypertension,their blood pressure(BP)control status,and associated factors that may influence service utilization and BP control,by analyzing the Electronical Health Record(EHR)of a community health service center in Beijing.Methods:Data of patients with hypertension were collected from the EHR from January 1 to December 31,2016.Patients' demographics,frequencies of visiting the department of general practice(GP)of the community health service center for hypertension,and status of BP control were described.Univariable and multivariable regression analysis were used to identify factors influencing the utilization of CHS and BP control in patients with hypertension.Results:98.9%of the patients with hypertension were over 40 years old.98.6%of them had medical insurance.More than 70%had complication of either diabetes mellitus,coronary heart disease or stroke.44.7%participated the rigorous management of chronic non-communicable diseases program.93.8%visited the community health service center chronic non-communicable diseases program.34 regression analysis found that age(OR 1.82,95%CI 1.30-2.54 for patients>65 years old,P<0.001);rigorous management(OR 5.47,95%CI 3.47-8.62,P<0.001)and comorbidities(OR 11.24,95%CI 5.22-24.20 for two comorbidities,P<0.001;OR 23.84,95%CI 3.31-171.70,P=0.002 for three comorbidities)influenced the utilization of CHS significantly.More than 95%of the patients had blood pressure controlled well.Rigorous management was found to have no significant association with BP control(P>0.05).Conclusions:1)The patients with hypertension who visited the community health service center for hypertension were mainly middle-aged or elderly people,and most of them had medical insurance and comorbidities.2)The patients with hypertension had high utilization of CHS.Elderly people,those who participated rigorous management program,and who had comorbidities utilized CHS more often.3)The blood pressure control rate of patients in this community was high,which was not associated with rigorous management.