Low utilization of health care services following screening for hypertension in Dar es Salaam (Tanzania): a prospective population-based study.
Low utilization of health care services following screening for hypertension in Dar es Salaam (Tanzania): a prospective population-based study.
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筛查高血压（坦桑尼亚）的高血压后，医疗保健服务的利用率较低：一项基于人群的前瞻性研究。
DOI：
10.1186/1471-2458-8-407
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发表时间：
2008-12-16
影响因子：
4.5
通讯作者：
Paccaud F
中科院分区：
文献类型：
--
作者：
Bovet P;Gervasoni JP;Mkamba M;Balampama M;Lengeler C;Paccaud F
在低收入国家，高风险人群的药物治疗一直被认为是减少心血管疾病的重要策略。我们确定，在低收入的城市人口中，在被诊断为高血压并建议寻求医疗保健以进一步管理高血压后使用医疗服务的人的比例。在达累斯萨拉姆对9 254名25-64岁的人进行了一项基于人口的调查。在初次接触时患有高血压（此处定义为BP ≥ 160/95 mmHg）的540人中，253人（47%）在45天后的第4次访视时血压升高。其中，208人未经治疗，并建议在他们选择的健康中心接受医疗保健，以进一步管理他们的高血压。一年后，161人再次接受访问，并询问他们在此期间使用卫生服务的情况。在161名建议寻求医疗保健的高血压患者中，34%的人报告在12个月的时间间隔内参加了正式的医疗保健提供者（63%公共设施; 30%私人; 7%两者兼而有之）。34%的患者在某个时间点接受了抗高血压治疗（表明对卫生服务的接受程度较差），12个月随访结束时有3%的患者接受了抗高血压治疗（表明长期依从性较差）。卫生服务利用倾向于与年龄较大、既往高血压史、超重和不吸烟有关，但与教育或财富无关。没有症状和治疗费用是报告的不去保健的最常见原因。高血压筛查后卫生服务的低利用率表明，以患者为中心的筛查和治疗策略对低收入人群的影响很小。这些研究结果强调，需要确定和解决在这种情况下利用卫生保健治疗非传染性疾病的障碍，并间接强调公共卫生措施对这些疾病的初级预防的重要性。
Drug therapy in high-risk individuals has been advocated as an important strategy to reduce cardiovascular disease in low income countries. We determined, in a low-income urban population, the proportion of persons who utilized health services after having been diagnosed as hypertensive and advised to seek health care for further hypertension management. A population-based survey of 9254 persons aged 25–64 years was conducted in Dar es Salaam. Among the 540 persons with high blood pressure (defined here as BP ≥ 160/95 mmHg) at the initial contact, 253 (47%) had high BP on a 4th visit 45 days later. Among them, 208 were untreated and advised to attend health care in a health center of their choice for further management of their hypertension. One year later, 161 were seen again and asked about their use of health services during the interval. Among the 161 hypertensive persons advised to seek health care, 34% reported to have attended a formal health care provider during the 12-month interval (63% public facility; 30% private; 7% both). Antihypertensive treatment was taken by 34% at some point of time (suggesting poor uptake of health services) and 3% at the end of the 12-month follow-up (suggesting poor long-term compliance). Health services utilization tended to be associated with older age, previous history of high BP, being overweight and non-smoking, but not with education or wealth. Lack of symptoms and cost of treatment were the reasons reported most often for not attending health care. Low utilization of health services after hypertension screening suggests a small impact of a patient-centered screen-and-treat strategy in this low-income population. These findings emphasize the need to identify and address barriers to health care utilization for non-communicable diseases in this setting and, indirectly, the importance of public health measures for primary prevention of these diseases.
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影响因子：
168.9
作者：
Gaziano, Thomas A.;Galea, Gauden;Reddy, K. Srinath
通讯作者：
Reddy, K. Srinath
影响因子：
4.9
作者：
Mendis, S;Abegunde, D;Nordet, P
通讯作者：
Nordet, P
影响因子：
168.9
作者：
Walker, RW;McLarty, DG;Alberti, KGMM
通讯作者：
Alberti, KGMM
影响因子：
4.9
作者：
Mendis, Shanthi;Lindholm, Lars H.;Heagerty, Tony
通讯作者：
Heagerty, Tony
影响因子：
168.9
作者：
Lim, Stephen S.;Gaziano, Thomas A.;Rodgers, Anthony
通讯作者：
Rodgers, Anthony