PS 15-14 PATIENTS’ PERCEPTIONS OF HEALTH CARE MANAGEMENT AMONG CHINESE RURAL MIDDLE-AGED AND OLDER ADULTS WITH CARDIOVASCULAR CONDITIONS: A CROSS-SECTIONAL STUDY

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Abstract

Objective:

The population ageing and socio-economic inequality are common across China where the ability to pay for health care is dominant. Health care management in rural villages have largely been neglected. We aimed to provide information on the prevalence of common cardiovascular conditions among rural primary care patients whose perceptions of health care management were assessed.

Design and Method:

A cluster random sampling was performed to select patients (aged ≥ 50 years) at rural health infirmaries in eight villages from three countries in a typical county in southern China in 2014. Clinical parameters were measured on-site and disease histories were obtained from paper-based medical records. Hypertension and diabetes were diagnosed in accordance to national guidelines. Dyslipidemia were defined as having total cholesterol ≥ 5.69mmol/L, or triglycerides ≥ 1.69 mmol/L, or low-density lipoprotein cholesterol ≥ 3.62 mmol/L. The perception of health care management was measured by a validated interviewer-administered questionnaire.

Results:

Data were available from 4,670 out of 4,800 patients, with an average age of 65.3 ± 7.1 years. Nearly two thirds (62.1%, 95%CI 58.9–65.2) had ≥ 2 cardiovascular conditions, with no significant gender differences (61.6% for males; 62.5% for females). Nearly half (45.8%) had primary education level or below. Hypertension (54.6%) and dyslipidemia (43.3%) were most prevalent, followed by diabetes (25.3%), coronary heart disease (15.9%) and stroke (3.9%). Among those with cardiovascular multimorbidity, 65.3% of subjects received a perception score ≤ 2 out of 10, indicating poor recognition of health care management. Less than one in ten (7.7%) of these respondents were willing to pay for regular health examinations and risk evaluations only when services were deemed affordable.

Conclusions:

There is a high prevalence of cardiovascular comorbidities among middle-aged and elderly patients in the rural health infirmary setting. Health care management services in rural areas seem to be currently under-developed, probably due to the unaffordablility of patients and their families.

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