2
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      To submit your manuscript to JMIR, please click here

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Internet Access and Hypertension Management Among the Elderly Population: A Nationally Representative Cross-Sectional Survey in China

      research-article
      , PhD 1 , , PhD 2 , , PhD 3 , , PhD 3 , , PhD 3 ,
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      China, health disparity, hypertension, internet

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Hypertension is a rapidly growing epidemic in China. Yet, it remains inadequately controlled, especially in rural areas. The internet has shown potential for better health management in different settings; however, few studies have investigated its role in hypertension management in China.

          Objective

          This study aims to examine the association between internet access and hypertension awareness, treatment, and control among elderly Chinese adults and to investigate whether the association between internet access and hypertension management differed between those living in urban and rural areas.

          Methods

          We obtained data from the nationally representative survey of the China Health and Retirement Longitudinal Study in 2011. Hypertension was defined as (1) average systolic blood pressure of ≥140 mm Hg or average diastolic blood pressure of ≥90 mm Hg or (2) currently taking antihypertensive medications. The outcome assessed included hypertension awareness, treatment, and control. The key independent variable was defined as whether one had internet access at home. We performed multivariate logistic regressions for each of the 3 outcomes.

          Results

          Among 5135 hypertensive respondents (age 62.4 [SD 9.9] years; 2351/5135, 45.78% men), 12.89% (662/5135) had internet access at home. Compared with those who had no internet access, internet access was positively associated with hypertension awareness (odds ratio [OR] 1.36, 95% CI 1.07-1.73) and treatment (OR 1.38, 95% CI 1.09-1.75), but not with control (OR 1.19, 95% CI 0.90-1.58). Internet access reduced urban-rural disparity in hypertension awareness by 9.6% ( P=.02), treatment by 8.3% ( P=.05), but not in control. In addition, the moderating effect of internet access on urban-rural disparities in hypertension management was larger among females. The decreased urban-rural disparities were primarily driven by that internet access improved the management level in rural areas.

          Conclusions

          Despite the low rate of internet access among the elderly population, the internet shows its potential as a platform for achieving better hypertension management in China. Strategies for reducing the disparities in hypertension management and overall disease burden of hypertension among the elderly population might consider the internet as a platform.

          Related collections

          Most cited references17

          • Record: found
          • Abstract: found
          • Article: not found

          Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey.

          Hypertension is one of the major risk factor for cardiovascular disease worldwide. The objective of this study was to investigate the prevalence, awareness, treatment, and control of hypertension in China. A multistage, stratified sampling method was used to obtain a representative sample of persons aged 18 years or older in the general population of China. Blood pressure (BP) was measured by sphygmomanometer 3 times at 5-minute intervals. Hypertension was defined as a systolic BP ≥ 140mm Hg, or diastolic BP ≥ 90mm Hg, or self-reported use of antihypertensive medications in the last 2 weeks irrespective of the BP. Altogether 50,171 subjects finished the survey across the entire country. The adjusted prevalence of hypertension was 29.6% (95% confidence interval (CI) = 28.9%-30.4%) and was higher among men than among women (31.2%, 95% CI = 30.1%-32.4%; vs. 28.0%, 95% CI = 27.0%-29.0%). The awareness, treatment among all hypertensive participants, control among all hypertensive participants, and control among treated hypertensive participants were 42.6%, 34.1%, 9.3%, and 27.4%, respectively. Multiple lifestyle factors were independently associated with presence of hypertension, including physical inactivity, habitual drinking, chronic use of nonsteroidal anti-inflammatory drugs, high body mass index, and central obesity. Hypertension is an important public health burden in China, and control of hypertension is still suboptimal. Several modifiable lifestyle activities were associated with hypertension and thus should be considered potential targets for intervention, with special attention to socioeconomically disadvantaged subpopulations in China. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Harnessing the privatisation of China's fragmented health-care delivery

            Summary Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail—population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              China's human resources for health: quantity, quality, and distribution.

              In this paper, we analyse China's current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses-in 2005, there were 1.9 million licensed doctors and 1.4 million nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Most of China's doctors (67.2%) and nurses (97.5%) have been educated up to only junior college or secondary school level. Since 1998 there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce. Inter-county inequality in the distribution of both doctors and nurses is very high, with most of this inequality accounted for by within-province inequalities (82% or more) rather than by between-province inequalities. Urban-rural disparities in doctor and nurse density account for about a third of overall inter-county inequality. These inequalities matter greatly with respect to health outcomes across counties, provinces, and strata in China; for instance, a cross-county multiple regression analysis using data from the 2000 census shows that the density of health workers is highly significant in explaining infant mortality.
                Bookmark

                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                January 2019
                31 January 2019
                : 21
                : 1
                : e11280
                Affiliations
                [1 ] Department of Global Health School of Public Health Peking University Beijing China
                [2 ] Department of Public Health Shihezi University School of Medicine Xinjiang China
                [3 ] China Center for Health Development Studies Peking University Beijing China
                Author notes
                Corresponding Author: Xiaochen Ma xma@ 123456hsc.pku.edu.cn
                Author information
                http://orcid.org/0000-0003-0634-3955
                http://orcid.org/0000-0003-4986-0127
                http://orcid.org/0000-0003-1051-6177
                http://orcid.org/0000-0003-1934-632X
                http://orcid.org/0000-0002-8251-3373
                Article
                v21i1e11280
                10.2196/11280
                6374727
                30702439
                6c6ff8ec-d502-47ba-876a-899706e51e1b
                ©Yinzi Jin, Mingxia Jing, Luyu Zhang, Suhang Song, Xiaochen Ma. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 31.01.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/.as well as this copyright and license information must be included.

                History
                : 17 June 2018
                : 6 September 2018
                : 30 October 2018
                : 1 November 2018
                Categories
                Original Paper
                Original Paper

                Medicine
                china,health disparity,hypertension,internet
                Medicine
                china, health disparity, hypertension, internet

                Comments

                Comment on this article