Aleli D. Kraft , Joseph J. Capuno , Kayleen Gene R. Calicdan , Grace T. Cruz , Owen O'Donnell
{"title":"菲律宾老年人高血压筛查机会的错失:对具有全国代表性的个人层面数据的横截面分析","authors":"Aleli D. Kraft , Joseph J. Capuno , Kayleen Gene R. Calicdan , Grace T. Cruz , Owen O'Donnell","doi":"10.1016/j.lanwpc.2024.101188","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Guidelines recommend routine blood pressure measurement at health facilities. We estimated the potential for opportunistic screening for hypertension at health facilities to change the level and distribution of diagnosed hypertension in the older population of the Philippines.</p></div><div><h3>Methods</h3><p>We used a representative, nationwide sample of Filipinos aged 60 years and older and classified respondents as a) <em>hypertensive</em> if they had high (≥140/90 mm Hg) blood pressure (BP) or were taking BP medication, b) <em>diagnosed</em> if told have high BP by a doctor, and c) a <em>missed opportunity for diagnosis</em> if they were hypertensive, undiagnosed and had an outpatient visit to a health facility in the past 12 months. We assumed c) would be diagnosed if health facilities operated opportunistic screening. We estimated percentages of hypertensives diagnosed and with a missed opportunity overall, by wealth quintile and covariates, with age-sex and, then, full adjustment.</p></div><div><h3>Findings</h3><p>We estimated that opportunistic screening at health facilities would increase the percentage of hypertensives diagnosed from 62.7% (95% CI: 58.2, 67.0) to 74.4% (95% CI: 70.9, 77.6). The increase would be larger in richer groups due to lower (private) healthcare utilization by poorer, undiagnosed hypertensives.</p></div><div><h3>Interpretation</h3><p>Opportunistic screening for hypertension, if effectively implemented at health facilities, would substantially increase diagnosis but exacerbate inequality unless barriers discouraging poorer, older Filipinos from accessing outpatient and primary care were lowered.</p></div><div><h3>Funding</h3><p><span>Economic Research Institute for ASEAN and East Asia</span>, <span>Swiss Agency for Development and Cooperation</span>/<span>Swiss National Science Foundation</span> grant <span><span>400640_160374</span></span>.</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001822/pdfft?md5=6e59f9621971c2c5b329e16771413001&pid=1-s2.0-S2666606524001822-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Missed opportunities for hypertension screening of older people in the Philippines: cross-sectional analysis of nationally representative individual-level data\",\"authors\":\"Aleli D. Kraft , Joseph J. Capuno , Kayleen Gene R. Calicdan , Grace T. Cruz , Owen O'Donnell\",\"doi\":\"10.1016/j.lanwpc.2024.101188\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Guidelines recommend routine blood pressure measurement at health facilities. We estimated the potential for opportunistic screening for hypertension at health facilities to change the level and distribution of diagnosed hypertension in the older population of the Philippines.</p></div><div><h3>Methods</h3><p>We used a representative, nationwide sample of Filipinos aged 60 years and older and classified respondents as a) <em>hypertensive</em> if they had high (≥140/90 mm Hg) blood pressure (BP) or were taking BP medication, b) <em>diagnosed</em> if told have high BP by a doctor, and c) a <em>missed opportunity for diagnosis</em> if they were hypertensive, undiagnosed and had an outpatient visit to a health facility in the past 12 months. We assumed c) would be diagnosed if health facilities operated opportunistic screening. We estimated percentages of hypertensives diagnosed and with a missed opportunity overall, by wealth quintile and covariates, with age-sex and, then, full adjustment.</p></div><div><h3>Findings</h3><p>We estimated that opportunistic screening at health facilities would increase the percentage of hypertensives diagnosed from 62.7% (95% CI: 58.2, 67.0) to 74.4% (95% CI: 70.9, 77.6). The increase would be larger in richer groups due to lower (private) healthcare utilization by poorer, undiagnosed hypertensives.</p></div><div><h3>Interpretation</h3><p>Opportunistic screening for hypertension, if effectively implemented at health facilities, would substantially increase diagnosis but exacerbate inequality unless barriers discouraging poorer, older Filipinos from accessing outpatient and primary care were lowered.</p></div><div><h3>Funding</h3><p><span>Economic Research Institute for ASEAN and East Asia</span>, <span>Swiss Agency for Development and Cooperation</span>/<span>Swiss National Science Foundation</span> grant <span><span>400640_160374</span></span>.</p></div>\",\"PeriodicalId\":22792,\"journal\":{\"name\":\"The Lancet Regional Health: Western Pacific\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666606524001822/pdfft?md5=6e59f9621971c2c5b329e16771413001&pid=1-s2.0-S2666606524001822-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Lancet Regional Health: Western Pacific\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666606524001822\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Lancet Regional Health: Western Pacific","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666606524001822","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Missed opportunities for hypertension screening of older people in the Philippines: cross-sectional analysis of nationally representative individual-level data
Background
Guidelines recommend routine blood pressure measurement at health facilities. We estimated the potential for opportunistic screening for hypertension at health facilities to change the level and distribution of diagnosed hypertension in the older population of the Philippines.
Methods
We used a representative, nationwide sample of Filipinos aged 60 years and older and classified respondents as a) hypertensive if they had high (≥140/90 mm Hg) blood pressure (BP) or were taking BP medication, b) diagnosed if told have high BP by a doctor, and c) a missed opportunity for diagnosis if they were hypertensive, undiagnosed and had an outpatient visit to a health facility in the past 12 months. We assumed c) would be diagnosed if health facilities operated opportunistic screening. We estimated percentages of hypertensives diagnosed and with a missed opportunity overall, by wealth quintile and covariates, with age-sex and, then, full adjustment.
Findings
We estimated that opportunistic screening at health facilities would increase the percentage of hypertensives diagnosed from 62.7% (95% CI: 58.2, 67.0) to 74.4% (95% CI: 70.9, 77.6). The increase would be larger in richer groups due to lower (private) healthcare utilization by poorer, undiagnosed hypertensives.
Interpretation
Opportunistic screening for hypertension, if effectively implemented at health facilities, would substantially increase diagnosis but exacerbate inequality unless barriers discouraging poorer, older Filipinos from accessing outpatient and primary care were lowered.
Funding
Economic Research Institute for ASEAN and East Asia, Swiss Agency for Development and Cooperation/Swiss National Science Foundation grant 400640_160374.
期刊介绍:
The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.