An evaluation of the effects of general practitioner–supported patient noncommunicable diseases control model in Shanghai, China

Abstract

Summary Noncommunicable diseases (NCDs) are the leading cause of death worldwide. A litmus test for China's health reform is its ability to effectively deal with NCDs. The general practitioners (GPs)–supported NCD control model was designed to address ways to effectively prevent and control NCDs population‐wide. This study aimed to evaluate the GPs‐supported NCD control model and its effect on China's NCD control. The model was structured with three layers of two‐way relationships between patients, GPs, and specialists. The four technologies included the community‐based NCD self‐management model, the electronic clinical‐pathways–supporting community NCD intervention, the largest regional independent medical information system engaged by the Shanghai Healthcare Cloud, and continuous and successive policy intervention. Under the influence of the model, hypertension awareness, treatment, and control were the highest in Shanghai. By 31 August 2017, 131 453 users declined to use the mobile application while 10 444 completed the type 2 diabetes mellitus (T2DM) risk assessment. By 15 August 2017, 249 000 residents had participated in early detection and screening, leading to the identification of 29 304 (11.8%) being in a prediabetic state and 24 422 (9.8%) being newly diagnosed with T2DM. From 2012 to 2016, 208 537 patients were newly identified with hypertension using Internet‐connected devices and hypertension awareness increased 5.7%. After implementing the self‐management interventions, patients' blood pressure was controlled at around 90% (from 2007 to 2015). This pilot model in Shanghai suggested positive social benefits and appears to have played an important role in advancing NCD control in China.

Changes of Multisectoral Collaboration and Service Delivery in Hypertension Prevention and Control before and after the 2009 New Healthcare Reform in China: An Interrupted Time-Series Study

“…Some provinces in the eastern region explored hypertension management at the primary care level. Beijing and Shanghai carried out community intervention trials for hypertension management before 2000 [ 50 ] and subsequently evaluated the effectiveness of the project [ 52 , 54 ]. The Disease Control Bureau of the former Ministry of Health selected 23 provinces for pilot projects in 2005 to explore the model and experience of standardized management of hypertension in the community, covering most provinces in the eastern region [ 10 ].…”

The effect of patient perceived involvement on patient loyalty in primary care: The mediating role of patient satisfaction and the moderating role of the family doctor contract service

“…Our results confirmed the value of patient involvement through an empirical research, which implied health managers that patient active involvement in the doctor-patient consultation is helpful to coordinate patients' reasonable and efficient use of primary care. Establishing patient-centred health management strategies and making patients fully participate in primary health care, including the formulation of health plans and management of chronic disease, 76 will be conducive for patients' first choices and subsequent utilization of health services from primary health care facilities. Therefore, health managers should encourage patients to participate in the medical visits as much as possible by promoting and popularizing the shared medical decision as well as training physicians in developing skills to facilitate patient involvement and decision making.…”

Association of Acupuncture Treatment with Mortality of Type 2 Diabetes in China: Evidence of a Real-World Study

“…The World Health Organization (WHO) recommends that countries take effective measures to prevent and treat diabetes [11]. Accordingly, the WHO and the National Institutes of Health reported that acupuncture could be an effective means to treat diabetes [12].…”