Study On The Relationship Between The Control Rate Of Hypertension And Drugs In Outpatient Among Different Grade Hospital Of Chongqing City

Objective: to analyze the therapy of hypertensive outpatients amongdifferent grade hospitals in Chongqing，Types of drugs，the relationshipbetween using a antihypertensive drugs alone or combined, drugprice，daily total cost of drugs and control rate.Methods: a cross-sectional epidemiological survey was used,2742casesof hypertension patients were random questionnaire who comes fromdifferent grade hospitals in the city of Chongqing and the surroundingarea countys (including: standard measurement of blood pressure,according to the inclusion and exclusion criteria, fill the pre-designedquestionnaire, strict examination, sort out and input patient data, using thecorresponding statistical methods to analyze data).Results: the average hypertension control rate in outpatients inChongqing was46%, the hypertension control rate in the first grade,second grade, third grade hospitals were38.7%,46.7%,51.1%, threelevel of hospital outpatient hypertension patients control rate had significant difference(χ~2=28.787P=0.000)；comparison of two two levels:The control rate of first grade hospitals (38.7%) respectively comparedwith the second grade hospitals (46.7%)or the third grade hospitals(51.1%),the difference was statistically significant (χ2=11.407, P=0.001;χ2=28.500, P=0.000).The control rate of Using a kind ofantihypertensive drugs alone in the first grade, second grade, third gradehospitals were:40.12%(205/511),42.37%(150/354) and48.50%(230/474), There is significant difference between the threegroups(χ~2=7.401P=0.025), the first grade hospitals(40.12%) and thirdgrade hospitals (48.50%) were compared, there was statisticallysignificant difference (χ2=7.046, P=0.008).The control rate of thecombined use of antihypertensive drugs in the first grade, second grade,third grade hospitals were:36.25%（112/309）、49.54%（271/547）and53.40%（292/547），There is significant difference between the threegroups(χ~2=23.962P=0.000)， when the first grade hospitals(36.25%)compared with the second grade hospitals(49.54%) or the thirdgrade hospitals (53.40%),there was statistically significant (χ~2=23.266P=0.000； χ~2=14.121P=0.000).In the first grade hospitals,193patientswere treated with the traditional formula of compound preparation whichcontrol rate was33.68%(65/193cases).In the first grade hospitals67.8%of patients chose low price of drugs, the second grade hospital have8.7%,and the third grade hospitals have12.5%, which was statistically significan（tχ~2=645.473P=0.000；χ~2=594.913P=0.000）; at the same timein first grade hospitals only0.4%patients used the high price of drugs,but the second and third hospitals are47.6%and51.8%, which has theobvious statistical significance.（χ~2=509.739P=0.000； χ~2=585.797P=0.000）. Using the medium price of drugs, the second gradehospitals(43.7%) and the first grade hospitals（31.8%） comparison, Thedifference was statistically significant, but also have statisticallysignificant when the the second grade hospitals VS the third gradehospitals（35.7%）（,χ~2=25.787P=0.000；χ~2=13.026P=0.000）. The thirdhospitals use low price of slightly more than second grade hospitals（χ~2=7.529P=0.006）.The control rate of patients who Choose to use thelow price of drugs, moderate price drugs, high price of drugs are38.6%（294762）、48.7%（4961019）、48.9%（470961）， DifferentAntihypertensive drugs price to control blood pressure has statisticallysignificant（χ~2=23.08P=0.000）, Reflected in the use of low drug wascompared with the moderate price drugs and the high price drugs（χ~2=17.992P=0.000；χ~2=18.357P=0.000）.When Daily expenses ofAntihypertensive drugs in (0~2] yuan compared with (2~4] and (6~8]yuan had significant difference (χ2=8.698, P=0.003; χ2=12.051,P=0.001). Multivariate analysis showed that factors improve bloodpressure in patients with hypertension is: taking ACEI, taking in themedium price or high prices drug, treatment in the second hospitals and third hospitals.Conclusion: the control rate of hypertension patients among differentgrade hospitals in Chongqing city are still relatively low, especially inthe first grade hospitals, when to speed up the construction of secondgrade hospitals and third grade hospitals do not forget to strengthen thesupport for the construction of the first grade hospitals, to prevent thetwo stage differentiation situation, a full range to improve the control rateof outpatient service hypertension of our country. Combination controlrate is low, so early, aggressive, standardized combination needs attention;The first grade hospitals drug model is old, too many patients choose thelow price of drugs which hindered the rate of blood pressure control. wecan Improve the situation by the patient’s own actual situation, the choiceof some medium price or high price drugs, using the more full ofevidence of antihypertensive drugs with evidence-based medicine.