Study on the application effect of family doctor contract service mode of "basic package + personalized package" in elderly hypertension management: Chinese experience

Abstract

Background At present, there is no relevant research on the application effect of "basic package + personalized package" family doctor contract service mode in hypertension management, therefore, this study intended to evaluate the application effect of this service model in the management of hypertension patients. We speculated that the implementation of this mode would improve the health outcomes of elderly patients with hypertension. Methods Patients with hypertension who participated in family doctor contract services in a community health service center in Chengdu, Southwest China from January 1, 2018 to December 31, 2020 were selected as the subjects of the study. According to the inclusion and exclusion criteria of the study, a total of 968 patients were included. The patients were divided into observation group and control group according to the type of service package they received. The primary outcomes included mean blood pressure (systolic, diastolic) and the rate of blood pressure control, Secondary outcomes included the level of cardiovascular disease risk and the level of self-management ability. All outcomes were assessed at baseline and 6 months after signing up. Results Of the 10,970 patients screened for eligibility, 968 (8.8%) were enrolled and divided into observation group (receiving "basic package + personalized package [hypertension]" service) (n = 403) and control group (receiving "basic package" service) (n = 565) according to the type of service package they received. Participants in the observation group compared with the control group showed better improvement in mean systolic blood pressure, the rate of blood pressure control, the level of cardiovascular disease risk, and the level of self-management ability at 6 months after signing up (Mean systolic blood pressure, P = 0.023; the rate of blood pressure control, P < 0.001; the level of cardiovascular disease risk, P < 0.001; the level of self-management ability, P < 0.001). There was no significant difference in mean diastolic blood pressure between the two groups (P = 0.735). Conclusions The family doctor contract service model of "basic package + personalized package (hypertension)" has a good application effect in the management of elderly hypertension, which can improve the average blood pressure, the rate of blood pressure control, the level of cardiovascular disease risk and the level of self-management ability of elderly hypertension patients.