Trajectories of Outpatient Service Utilisation of Hypertensive Patients in Tertiary Hospitals in China

Zijing Pan, Wanchun Xu, Zhong Li, Chengzhong Xu, Fangfang Lu, Pei Zhang, Liang Zhang and Ting Ye
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Zijing Pan: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
Wanchun Xu: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
Zhong Li: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
Chengzhong Xu: Yichang Centre for Disease Control and Prevention, Yichang 443000, China
Fangfang Lu: Yichang Centre for Disease Control and Prevention, Yichang 443000, China
Pei Zhang: Yichang Centre for Disease Control and Prevention, Yichang 443000, China
Liang Zhang: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
Ting Ye: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China

IJERPH, 2020, vol. 17, issue 3, 1-15

Abstract: This study aims to identify the characteristics and trajectories of outpatient service utilisation for hypertensive patients in tertiary hospitals. This study also attempts to investigate the determinants of the trajectories of outpatient service utilisation. A total of 9822 patients with hypertension and hypertension-related medical utilisation were recruited in Yichang, China from January 1 to December 31 in 2016. The latent trajectories of outpatient service utilisation were identified through latent class growth analysis. Differences in the demographic characteristics and medical utilisation among patients in different trajectories were tested by one-way ANOVA and chi-square analysis. The predictors of the trajectory groups of outpatient service utilisation were identified through multinomial logistic regression. Four trajectory groups were determined as stable-low (34.7%), low-fluctuating (13.4%), high-fluctuating (22.5%), and stable-high (29.4%). Significant differences were observed in all demographic characteristics ( p < 0.001) and medical service utilisation variables ( p < 0.001) among the four trajectories except for inpatient cost ( p = 0.072). Determinants for outpatient service utilisation patterns include the place of residence, education level, outpatient visit times, inpatient service utilisation, and outpatient cost. Overall, hypertensive patients visiting outpatient units in the tertiary hospital were middle-aged, elderly, and well-educated, and they received poor follow-up services. The four identified latent trajectories have different characteristics and medical utilisation patterns. Trajectory group-based measurements are necessary for hypertension management and economic burden reduction.

Keywords: hypertension; latent class growth analysis; medical expenditures; outpatient utilisation pattern (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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