Impact of intelligent family physician optimized coordination model On Primary Hypertension Patients in a Beijing Community (Preprint)
BACKGROUND In order to address the challenges of chronic diseases, Beijing Municipal Government promoted intelligent family physician optimized collaborative model ( IFOC ) schema, which is poised to implement the patient-centered healthcare model, supported by intelligent chronic disease management system. The Fangzhuang community health service center is a National Demonstration Community Health Service Center in China, laid emphasis on the patient-centered model service, initiated, piloted and promoted IFOC schema optimize management of chronic diseases. OBJECTIVE To explore the effect of an intelligent family physician optimized collaborative model on selected hypertension patients of Fangzhuang Community in Beijing. METHODS This retrospective study used de-identified data of hypertension patients from the database of Fangzhuang community health service center. A comparative study pre- and post-implementation of IFOC for 2 years was performed to evaluate standardized management rate of blood pressure (BP), BP values, BP control rate, lifestyle changes and blood lipid levels. Continuous variables and categorical variables were analyzed using paired t-test and χ2 test, respectively. RESULTS A total of 6929 hypertension cases met inclusion/exclusion criteria. Compared with the pre-index period, standardized management rate increased from 34.4% to 67.4% in the post-index period (p < 0.001). SBP decreased from 144.10 mmHg to 141.38 mmHg (p < 0.001). BP control rate of the high-risk patients and overall BP control rate enhanced from 35.2% to 48.8%, from 44.7% to 49.9% , respectively (both p < 0.001). BMI decreased from 25.31 kg/m² to 24.65 kg/m².Exercise frequency increased from 2.83 times/week to 5.39 times/week; exercise duration increased from 20.03 min/d to 31.93 min/d; salt intake decreased from 9.56 g/d to 6.81 g/d; amount of cigarette smoking decreased from 11.31/d to 7.16 /d (all p < 0.005). TC decreased from 5.36 mmol/L to 4.65 mmol/L, LDL-C decreased from 3.35 mmol/L to 3.07 mmol/L (both p< 0.001), TG decreased from 1.79 mmol/L to 1.66 mmol/L (p= 0.021). CONCLUSIONS IFOC is an effective model in the management of hypertension and should be promoted and popularized by the Community Health Service Center in China as well as in other developing countries.