Evalution of nationeide hospital BP intervention

Abstract

Hypertension is a common disease, with an estimated 1.3 billion people aged 30-79 worldwide suffering from it, two-thirds of whom live in low- and middle-income countries. According to the 6th National Health Examination Survey of the Thai population aged 15 years and older, the prevalence of hypertension is as high as 25.2% of the population. It is a major cause of serious complications such as ischemic heart disease and stroke, which are leading causes of premature death in Thailand. Additionally, the survey revealed that 48.8% of hypertension patients had not been previously diagnosed. Early detection of undiagnosed hypertension, particularly in patients with severe hypertension who are at high risk, and ensuring they receive timely treatment can prevent dangerous complications and reduce premature mortality. Nationwide Hospital BP project, which aims to identify patients with severe hypertension among outpatients in hospitals across the country and ensure they receive a diagnosis and continuous care, is a significant initiative. Its objectives are to accelerate the diagnosis of hypertension, reduce the number of undiagnosed patients, and lower premature deaths due to complications in individuals unaware of their condition. This research sought to evaluate the project’s implementation over a three-year period, from 2022 to 2024, by assessing changes in the average percentage of hypertension diagnoses among patients with severe hypertension, using data from the HDC database. The differences in averages across the three fiscal years were analyzed using repeated measures ANOVA, while factors related to the project’s success and challenges were examined through survey data. The average percentage of hypertension diagnosed in the second year (25.79%) and the third year (25.44%) was significantly different, at a 95% confidence level, compared to the first year (20.44%). However, no significant difference was found between the second and third years. Based on these findings, it is recommended to develop additional supportive measures informed by qualitative data. These include: enhancing supportive factors, developing alert systems for hypertension detection, securing administrative support, broadly communicating hypertension management guidelines, addressing barrier by tackling delayed diagnoses by organizing meetings to review guidelines within medical organizations, systems improvement for verifying diagnoses and scheduling follow-up appointments.