Factors Related to the Outpatient Visits for Blood Pressure Management in Patients diagnosed with Hypertension

고혈압 진단자의 혈압 관리를 위한 외래 방문 영향요인

  • Cho, Hyung-Kyung (Department of Health Administration, Yonsei University Graduate School) ;
  • Lee, Hyun-Ji (Department of Health Administration, Yonsei University Graduate School) ;
  • Seol, Jin-Ju (Department of Health Administration, Yonsei University Graduate School) ;
  • Lee, Kwang-Soo (Department of Health Administration, Yonsei University Graduate School)
  • 조형경 (연세대학교 일반대학원 보건행정학과) ;
  • 이현지 (연세대학교 일반대학원 보건행정학과) ;
  • 설진주 (연세대학교 일반대학원 보건행정학과) ;
  • 이광수 (연세대학교 일반대학원 보건행정학과)
  • Received : 2021.06.01
  • Accepted : 2021.06.15
  • Published : 2021.06.30

Abstract

Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.

Keywords

References

  1. Murray CJ, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258);1223-1249. https://doi.org/10.1016/S0140-6736(20)30752-2
  2. World Health Organization. Top 10 cause of death [Internet]. Geneva (CH): World Health Organization; 2016 [cited 2020 Oct 30]. Available from: https://www.who.int/data/gho/data/themes/topics/causes-of-death.
  3. The Korean Society of Hypertension. Korea hypertension fact sheet 2020. Seoul (KOR): The Korean Society of Hypertension; 2020;12-13.
  4. Ahn KT, Jin SA, Jeong JO. Diagnosis and Treatment of Hypertension: Based on the Guidelines of the Korean Society of Hypertension. J Korean Neurol Assoc 2019;37(2);123-134. https://doi.org/10.17340/jkna.2019.2.2
  5. The Korean Society of Hypertension. 2019 Standard education slide for high blood pressure (Experts). Seoul (KOR): The Korean Society of Hypertension; 2020.
  6. Zhou B, Danaei G, Stevens GA, Bixby H, Taddei C, Carrillo-Larco RM, et al. Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet 2019;394(10199);639-651. https://doi.org/10.1016/s0140-6736(19)31145-6
  7. Kang SH, Kim SH, Cho JH, Yoon CH, Hwang SS, Lee HY, et al. (2019). Prevalence, awareness, treatment, and control of hypertension in Korea. Scientific Reports 2019;9(1);1-8. https://doi.org/10.1038/s41598-018-37186-2
  8. Chang DM, Park IS, Yang JH. Related Factors of Awareness, Treatment, and Control of Hypertension in Korea : Using the Fourth Korea National Health & Nutrition Examination Survey. J Digital Convergence 2013;3(5);509-519. https://doi.org/10.14400/JDPM.2013.11.11.509
  9. Park JE, Park JH, Chang SJ, Lee JH, Kim SY. The determinants of and barriers to awareness and treatment of hypertension in the Korean population. Asia Pac J Public Health 2019;31(2); 121-135. https://doi.org/10.1177/1010539518825006
  10. Bovet P, Gervasoni JP, Mkamba M, Balampama M, Lengeler C, Paccaud, F. Low utilization of health care services following screening for hypertension in Dar es Salaam (Tanzania): a prospective population-based study. BMC Public Health 2008;8:407;1-8. https://doi.org/10.1186/1471-2458-8-407
  11. Chang YK, Lee KS, Khang YH, Yim J, Choi YJ, Lee HK, et al. Health Behaviors Related to Hypertension in Rural Population of Korea. Korean J Prev Med 2000;33(1);56-68.
  12. Wilber JA, Barrow, JG. Hypertension:: a community problem. Am J Med 1972;52(5);653-663. https://doi.org/10.1016/0002-9343(72)90055-1
  13. Wilber JA. The problem of undetected and untreated hypertension in the community. J Urban Health 1973;49(6);510-520.
  14. Marques-Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community: is the 'rule of halves' still valid?. J Hum Hypertens 1997;11(4);213-220. https://doi.org/10.1038/sj/jhh/1000426
  15. Korea Disease Control and Prevention Agency. 2018 National health statistics. Cheongju (KOR): Korea Disease Control and Prevention Agency; 2020;234-240
  16. Ministry of Health and Welfare, Korea Health Promotion Institute. 2019 The results of pilot programs for chronic disease management in primary care. 2020;16.
  17. Korea Disease Control and Prevention Agency. 2019 Guidance on Community Health Survey. 2020;1-240.
  18. Anthony H, Valinsky L, Inbar Z, Gabriel C, Varda S. (2012). Perceptions of hypertension treatment among patients with and without diabetes. BMC Fam Pract 2012;13(1);1-7. https://doi.org/10.1186/1471-2296-13-1
  19. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav 1995;36(1);1-10. https://doi.org/10.2307/2137284
  20. Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc 1973;51(1);95-124. https://doi.org/10.2307/3349613
  21. Jeon HS, Kahng SK. Age Differences in the Predictors of medical service use between young-old and old-old: implications for medical service in aging society. Health and Social Welfare Review 2012;32(1);28-57. https://doi.org/10.15709/HSWR.2012.32.1.28
  22. Kim JG. (2008). Factors Affecting the Choice of Medical Care Use by the Elderly Person. KJGSW 2008;39;273-302.
  23. Choi HY, Ryu SY. Factors Associated with the Types of Unmet Health Care Needs among the Elderly in Korea. KJOHSM, 2017;11(2);65-79.
  24. KOSIS. Average monthly houseold income by 10 quantile(at least one person). [Internet]. Daejeon (KOR): Statistics Korea; 2020 [cited 2020 Oct 30]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1L9U044&vw_cd=MT_ZTITLE&list_id=G_A_10_001
  25. Enlund H, Jokisalo E, Wallenius S, Korhonen M. Patient-perceived problems, compliance, and the outcome of hypertension treatment. Pharm World Sci, 2001;23(2), 60-64. https://doi.org/10.1023/A:1011204216548
  26. Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L. et al. Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med 2005;143(6); 427-438. https://doi.org/10.7326/0003-4819-143-6-200509200-00007
  27. Seo YS, Park JH, Lim JH. Factors affecting regular medical services utilization of chronic disease patients - focusing on the hypertension, diabetes mellitus, hyperlipidemia. Korean J Health Educ Promot 2014;31(3);27-37.
  28. Youn KI. Medical utilization of hypertension patients. J Health Info Stat, 2013;38(1);39-53.
  29. Song HJ, Jang SM, Shin SY. (2012). Patterns of medical care utilization behavior and related factors among hypertensive patients: follow-up study using the 2003-2007 Korean Health Insurance Claims Data. Korean J Health Educ Promot, 2012;29(2);1-12.
  30. Kim KK. Rapid rise in education levels. Korean Social Trends 2008;79-87.
  31. Lee HM, Kim YM, Lee CH, Shin JH, Kim MK, Choi BY. Awareness, treatment and control of hypertension and related factors in the jurisdictional areas of primary health care posts in a rural community of korea. J Peve Med Public Health 2011;44(2);74-83. https://doi.org/10.3961/jpmph.2011.44.2.74
  32. Ko IS, Kim GS, Lim MH, Lee KJ, Wha LT, Park HS, et al. Effects of health education on the knowledge and self-care of hypertension for visiting nursing clients. J Korean Pubilc Health Nurs 2007;21(2);134-145.
  33. Park HA, Hwang JI. Patterns and determinants of health services utilization in korean adults. HSMR 2007;1(1);59-67.
  34. Ministry of Health and Welfare, HOO, Korea Health Promotion Institute, National Health Insurance Service, Health Insurance Review & Assessment service. 2020 Guidance on pilot programs for chronic disease management in primary care - 2nd revision. 2019;33-66.
  35. Kim SR, Shin HC, Lee DC, Kim CH, Sung EJ, Lee KH, et al. Use of the PHQ-2/PHQ-9 Serial Screening Instrument for Detecting Major Depressive Disorder in Primary Care. Korean J Str Res 2011;19(4);405-410.