Study On The Health Behavior Decision-making Of Hypertension And Comorbidity

Objective:To analyze the problems of health self-evaluation for hypertension patients and comorbidity,to explore the treatment path of hypertension patients,and to provide the relevant suggestions and strategies for improving their health quality of life.In order to offer ideas and reference for promoting the formation of disease classification and diagnosis hierarchical medical pattern for the sake of continuing health services can be provided for the residents of chronic diseases in China.Methods:The data stemmed from the monitored results of healthcare utilization among residents,a pilot survey initiated by the Statistics Information Center,National Health and Family Planning Commission of the PRC between July and December 2016.We mainly enrolled a sample of 1 536 hypertention patients and 331 patients with hypertension and diabetes with data for 6 consecutive months.We collected their sociodemographic characteristics,health utility scores measured by VAS,healthcare seeking status,treatment(especially inpatient treatment).X-Mind 7.5 was used to draw the treatment pathway map.The treatment in grassroots medical institutions and bi-directional referrals were analyzed in detail.Using the Anderson’s Behavioral model as the theoretical basis.This study examined the predisposing,enabling,and need factors that determine the single factor analysis,and construct the logistic regression model to analyze main factors affecting medical treatment decisions in patients with hypertension and comorbidity.Results:Among the 1 536 participants,There were 331 patients with hypertension and diabetes,with a total rate of 21.5%,and Hypertension comorbidity in 495 cases of other chronic diseases,the comorbidity rate was 32.2%.951(61.9%)were from urban areas;1 470(95.7%)received treatment[925(62.9%)of them receiving treatment from medical institutions].Of the 164 patients receiving only once outpatient treatment,113(68.9%)received it from the grassroots medical institutions.For 546 patients receiving multiple outpatient treatments from the same institution,372(68.1%)of them received the treatment from the grassroots medical institutions.With regard to 182 patients receiving multiple outpatient treatments from different institutions,106(58.2%)received the initial treatment from the grassroots medical institutions.The rate of receiving treatment from grassroots medical institutions among the patients varied significantly by region,annual household income per capita,prevalence of other diseases except hypertension(P<0.05).182 patients received totaled 663 treatments from different medical institutions,including 142(21.4%)treatments from the higher-level institutions,373(56.3%)treatments from different institutions of the same level,and 148(22.3%)treatments from the lower-level institutions.During multi-factor analysis about the factors chiefly selected were age,urban and rural,commercial medical insurance,annual income,VAS,self-care ability.Conclusion:Most hypertension patients sought medical care,and they often visited grassroots medical institutions,but the referrals were not successful enough.In view of this,precise interventions should be given to hypertension patients first then to hypertension patients with other chronic diseases seeking medical care in grassroots medical institutions based on the conditions of the area they from and their own income;hypertension patients from urban areas should be incentivized to seek medical care in lower level medical institutions;redundant referrals between medical institutions of the same level and redundant unidirectional referrals should be controlled standardizedly。...