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Health Insurance Coverage and Hypertension Control in China: Results from the China Health and Nutrition Survey

Author

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  • Yi Liao
  • Stuart Gilmour
  • Kenji Shibuya

Abstract

Background: China has rapidly expanded health insurance coverage over the past decade but its impact on hypertension control is not well known. We analyzed factors associated with hypertension and the impact of health insurance on the management of hypertension in China from 1991 to 2009. Methods and Findings: We used individual-level data from the China Health and Nutrition Survey (CHNS) for blood pressure, BMI, and other socio-economic variables. We employed multi-level logistic regression models to estimate the factors associated with prevalence and management of hypertension. We also estimated the effects of health insurance on management of hypertension using propensity score matching. We found that prevalence of hypertension increased from 23.8% (95% CI: 22.5–25.1%) in 1991 to 31.5% (28.5–34.7%) in 2009. The proportion of hypertensive patients aware of their condition increased from 31.7% (28.7–34.9%) to 51.1% (45.1–57.0%). The proportion of diagnosed hypertensive patients in treatment increased by 35.5% in the 19 years, while the proportion of those in treatment with controlled blood pressure remained low. Among diagnosed hypertensives, health insurance increased the probability of receiving treatment by 28.7% (95% CI: 10.6–46.7%) compared to propensity-matched individuals not covered by health insurance. Conclusions: Hypertension continues to be a major health threat in China and effective control has not improved over time despite large improvements in awareness and treatment access. This suggests problems in treatment quality, medication adherence and patient understanding of the condition. Improvements in hypertension management, quality of medical care for those at high risk, and better health insurance packages are needed.

Suggested Citation

  • Yi Liao & Stuart Gilmour & Kenji Shibuya, 2016. "Health Insurance Coverage and Hypertension Control in China: Results from the China Health and Nutrition Survey," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-14, March.
  • Handle: RePEc:plo:pone00:0152091
    DOI: 10.1371/journal.pone.0152091
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    References listed on IDEAS

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    1. Zijing Pan & Wanchun Xu & Zhong Li & Chengzhong Xu & Fangfang Lu & Pei Zhang & Liang Zhang & Ting Ye, 2020. "Trajectories of Outpatient Service Utilisation of Hypertensive Patients in Tertiary Hospitals in China," IJERPH, MDPI, vol. 17(3), pages 1-15, January.
    2. Yang Zhao & Ajay Singh Mahal & Tilahun Nigatu Haregu & Ameera Katar & Brian Oldenburg & Luwen Zhang, 2019. "Trends and Inequalities in the Health Care and Hypertension Outcomes in China, 2011 to 2015," IJERPH, MDPI, vol. 16(22), pages 1-13, November.
    3. Tian, Xu & von Cramon-Taubadel, Stephan, 2020. "Are only children in China more likely to be obese/overweight than their counterparts with siblings?," Economics & Human Biology, Elsevier, vol. 37(C).
    4. Hebe N Gouda & Andrew Hodge & Raoul Bermejo III & Willibald Zeck & Eliana Jimenez-Soto, 2016. "The Impact of Healthcare Insurance on the Utilisation of Facility-Based Delivery for Childbirth in the Philippines," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-15, December.
    5. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.

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