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

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Aleli D. Kraft , Joseph J. Capuno , Kayleen Gene R. Calicdan , Grace T. Cruz , Owen O'Donnell
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引用次数: 0

摘要

背景指南建议在医疗机构进行常规血压测量。我们估算了在医疗机构进行高血压机会性筛查对改变菲律宾老年人口中确诊高血压的水平和分布的可能性。方法 我们对 60 岁及以上的菲律宾人进行了具有代表性的全国性抽样调查,并将受访者划分为:a)血压高(≥140/90 mm Hg)或正在服用降压药的高血压患者;b)被医生告知血压高而确诊的高血压患者;c)在过去 12 个月内曾在医疗机构门诊就诊但未确诊的高血压患者。我们假定,如果医疗机构开展机会性筛查,c) 会被确诊。我们估算了已确诊和错过机会的高血压患者的总体百分比,并按财富五分位数和协变量进行了年龄-性别调整,然后进行了全面调整。结果我们估计,在医疗机构进行机会性筛查将使高血压患者的确诊百分比从 62.7% (95% CI: 58.2, 67.0) 提高到 74.4% (95% CI: 70.9, 77.6)。如果在医疗机构有效实施高血压机会性筛查,将大大提高诊断率,但会加剧不平等现象,除非降低阻碍较贫穷的菲律宾老年人获得门诊和初级保健服务的障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
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.
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