IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0217185.html
   My bibliography  Save this article

The role of the Basic Public Health Service program in the control of hypertension in China: Results from a cross-sectional health service interview survey

Author

Listed:
  • Jiangmei Qin
  • Yanchun Zhang
  • Masha Fridman
  • Kim Sweeny
  • Lifang Zhang
  • Chunmei Lin
  • Lu Mao

Abstract

Objectives: Non-communicable diseases (NCDs) have become the main cause of mortality in China. In 2009, the Chinese government introduced the Basic Public Health Service (BPHS) program to relieve the rising burden of NCDs through public health measures and delivery of essential medical care. The primary aim of this study was to evaluate the impact of the BPHS program on hypertension control. Methods: The China National Health Development Research Center (CNHDRC) undertook a Cross-sectional Health Service Interview Survey (CHSIS) of 62,097 people from primary healthcare reform pilot areas across 17 provinces from eastern, central, and western parts of China in 2014. The current study is based on responses to the CHSIS survey from 7,867 participants, who had been diagnosed with hypertension. Multi-variable mixed logit regression analysis was used to estimate the association between BPHS management and uncontrolled hypertension. In a follow-up analysis, generalized structural equation modelling (GSEM) was used to test for mediation of the BPHS program effect through patient compliance with medication. Findings: The estimated proportion of patients with uncontrolled hypertension was 30% lower (23.2% vs 31.5%) in those participants who were adequately managed under the BPHS program. Other predictors of hypertension control included compliance with medication, self-reported wellbeing, income, educational attainment and exercise; smoking was associated with reduced hypertension control. The significant inverse association between uncontrolled hypertension and age indicates poor outcomes for younger patients. Additional testing suggested that nearly 40% of the effect of BPHS management (95% CI: 28.2 to 51.7) could be mediated by improved compliance with medication; there was also an indication that the effect of management was 30% stronger in districts/counties with established digital information management systems (IMS). Conclusion: Hypertension control improved markedly following active management through the BPHS program. Some of that improvement could be explained by greater compliance with medication among program participants. This study also identified the need to tailor the BPHS program to the needs of younger patients to achieve higher levels of control in this population. Future investigations should explore ways in which existing healthcare management influences the success of the BPHS program.

Suggested Citation

  • Jiangmei Qin & Yanchun Zhang & Masha Fridman & Kim Sweeny & Lifang Zhang & Chunmei Lin & Lu Mao, 2021. "The role of the Basic Public Health Service program in the control of hypertension in China: Results from a cross-sectional health service interview survey," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-18, June.
    • Handle: RePEc:plo:pone00:0217185
    DOI: 10.1371/journal.pone.0217185
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0217185
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0217185&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0217185?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Bloom, Gerald & Xingyuan, Gu, 1997. "Health sector reform: Lessons from China," Social Science & Medicine, Elsevier, vol. 45(3), pages 351-360, August.
    2. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Daxu Li & Meixuan Luo & Yu Liu & Jing Dong & Wei Geng & Xiaoliu Li & Lijun Yang & Jin Wang & Peihua Cao, 2022. "Increased Rates of Health Management and Health Education on Hypertension and Diabetes in Inner Mongolia, China: 10-Year Population Level Trends (2009–2018)," IJERPH, MDPI, vol. 19(20), pages 1-8, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Schreyögg, Jonas, 2003. "Medical savings accounts: Eine internationale Bestandsaufnahme des Konzeptes der Gesundheitssparkonten," Discussion Papers 2003/11, Technische Universität Berlin, School of Economics and Management.
    2. Tajul Masron & Mduduzi Biyase & Talent Zwane & Thomas Udimal & Frederich Kirsten, 2023. "Ecological footprint and population health outcomes: an analysis of E7 countries," Economics Working Papers edwrg-07-2023, College of Business and Economics, University of Johannesburg, South Africa, revised 2023.
    3. Shawhan, Daniel L. & Picciano, Paul D., 2019. "Costs and benefits of saving unprofitable generators: A simulation case study for US coal and nuclear power plants," Energy Policy, Elsevier, vol. 124(C), pages 383-400.
    4. Shu Yan & Lizi Pan & Yan Lu & Juan Chen & Ting Zhang & Dongzi Xu & Zhaolian Ouyang, 2023. "Towards Sustainable Drug Supply in China: A Bibliometric Analysis of Drug Reform Policies," Sustainability, MDPI, vol. 15(13), pages 1-20, June.
    5. Bozena Wielgoszewska & Alex Bryson & Monica Costa-Dias & Francesca Foliano & Heather Joshi & David Wilkinson, 2021. "Exploring the Reasons for Labour Market Gender Inequality a Year into the Covid-19 Pandemic: Evidence from the UK Cohort Studies," DoQSS Working Papers 21-23, Quantitative Social Science - UCL Social Research Institute, University College London.
    6. Shi, Wunan & Wouters, Olivier J. & Liu, Gordon & Mossialos, Elias & Yang, Xiuyun, 2020. "Association between provincial income levels and drug prices in China over the period 2010–2017," Social Science & Medicine, Elsevier, vol. 263(C).
    7. Katie Adamek & Sarah Bardin & So O'Neil & Dara Lee Luca, "undated". "Accelerating Teen Pregnancy Prevention in Phillips County, Arkansas and Coahoma County, Mississippi," Mathematica Policy Research Reports 7fda86cbb1bf4303a84f466e8, Mathematica Policy Research.
    8. Chae, Minhee & Hatton, Timothy J. & Meng, Xin, 2023. "Explaining trends in adult height in China: 1950 to 1990," World Development, Elsevier, vol. 161(C).
    9. Han, Lu & Koenig-Archibugi, Mathias & Opsahl, Tore, 2018. "The social network of international health aid," Social Science & Medicine, Elsevier, vol. 206(C), pages 67-74.
    10. Burieva Nigora Hasanovna, 2019. "Models of Financing and Organization of Health Care System-International Experience," International Journal of Management Science and Business Administration, Inovatus Services Ltd., vol. 5(5), pages 7-12, July.
    11. Carolina Cortes-Herrera & Graciela Artavia & Silvia Quiros-Fallas & Eduardo Calderon-Calvo & Astrid Leiva & Josue Vasquez-Flores & Fabio Granados-Chinchilla, 2023. "Analysis of Minerals in Foods: A Three-year Survey from Costa Rican Market Products," Journal of Food Research, Canadian Center of Science and Education, vol. 12(1), pages 1-9, January.
    12. Victoria S S Wong & Lauro Nathaniel Avalos & Michael L Callaham, 2019. "Industry payments to physician journal editors," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-11, February.
    13. Ya-Ling Lin & Wen-Yi Chen & Shwn-Huey Shieh, 2020. "Age Structural Transitions and Copayment Policy Effectiveness: Evidence from Taiwan’s National Health Insurance System," IJERPH, MDPI, vol. 17(12), pages 1-17, June.
    14. Kyeong-Rae Kim & Jae-Eun Park & So-Young Lim & Ho Kim & Il-Tae Jang & Kwang-Yeol Lee, 2020. "Effects of Nutrition on Osteoarthritis in Women Over the 50 Years: Using the Korea National Health and Nutrition Examination Survey (KNHANES) Data," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(7), pages 1-29, June.
    15. Yu, Xuan & Li, Cheng & Shi, Yuhua & Yu, Min, 2010. "Pharmaceutical supply chain in China: Current issues and implications for health system reform," Health Policy, Elsevier, vol. 97(1), pages 8-15, September.
    16. Robert John Kolesar & Peter Bogetoft & Vanara Chea & Guido Erreygers & Sambo Pheakdey, 2022. "Advancing universal health coverage in the COVID-19 era: an assessment of public health services technical efficiency and applied cost allocation in Cambodia," Health Economics Review, Springer, vol. 12(1), pages 1-20, December.
    17. Segadlo, Nadine, 2021. "Navigating through an external agenda and internal preferences: Ghana's national migration policy," IDOS Discussion Papers 8/2021, German Institute of Development and Sustainability (IDOS).
    18. Liu, Chun & Wang, Lian, 2021. "Who is left behind? Exploring the characteristics of China's broadband non-adopting families," Telecommunications Policy, Elsevier, vol. 45(9).
    19. Khaleghian, Peyvand & Gupta, Monica Das, 2005. "Public management and the essential public health functions," World Development, Elsevier, vol. 33(7), pages 1083-1099, July.
    20. Townsend, Belinda & Schram, Ashley & Labonté, Ronald & Baum, Fran & Friel, Sharon, 2019. "How do actors with asymmetrical power assert authority in policy agenda-setting? A study of authority claims by health actors in trade policy," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0217185. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.