Objective:To investigate the current status and influencing factors of outpatient institution choice for hypertensive patients with basic medical insurance in Beijing, for reference to promote the implementation of the hierarchical medical system and guiding hypertensive patients to seek healthcare in primary care.Methods:Based on data of hypertensive outpatients from the basic medical insurance database of Beijing from April 2019 to January 2020, we analyzed major demographic characteristics of hypertensive patients, the selection of outpatient institutions and its influencing factors. The chi square test was used for comparison between groups, and the multivariate logistic regression model was used to analyze influencing factors.Results:2.842 1 million outpatients with hypertension were enrolled. 39.03% of them chose primary healthcare institutions, 5.16% chose secondary healthcare institutions, and 17.34% chose tertiary healthcare institutions, while the rest 38.47% chose two or more types of healthcare institutions. Gender, age, type of medical insurance, place of residence, utilization of Chinese herbal drugs, utilization of Chinese patent drugs, polypharmacy, needs of outpatient tests and examinations were the influencing factors for their selection of primary healthcare institutions for hypertensive outpatients under Beijing basic medical insurance.Conclusions:At present, the primary institutions have become the first choice for the majority of hypertensive patients with medical insurance in Beijing, but there are still many influencing factors on their choice of institutions. In the future, we should optimize the allocation of medical resources, promote the reform of medical insurance payment methods, strengthen the construction of primary medical institutions, expand the coverage of contracted services of family doctors, and reasonably guide the patients to seek healthcare in primary healthcare institutions.

OBJECTIVE To evaluate the cost-effectiveness of finerenone combined with standard treatment regimen in the treatment of diabetic nephropathy （DN）. METHODS From the perspective of healthcare service providers， a Markov model was established to simulate the dynamic changes of each stage in DN patients who received finerenone combined with the standard treatment regimen or the standard treatment regimen alone based on the phase Ⅲ clinical trial study of finerenone for DN. Markov model was used to perform the cost-effectiveness of long-term effects and the costs of the two therapies with a simulation cycle of 4 months， a simulation period of 15 years and an annual discount rate of 5%. At the same time， one-way sensitivity analysis and probability sensitivity analysis were performed， and the stability of the results was validated. RESULTS Accumulative cost of the standard treatment regimen was 579 329.54 yuan， and the accumulative utility was 8.052 4 quality-adjusted life year （QALYs）； the accumulative cost of finerenone combined with the standard treatment regimen was 332 520.61 yuan， and the accumulative utility was 8.187 4 QALYs. Finerenone combined with the standard treatment regimen was more cost-effective. The results of one-way sensitivity analysis showed that dialysis status utility value， DN stage 3 utility value and DN stage 4 utility value had a great influence on the incremental cost-effectiveness ratio， but did not affect the robustness of the model. The results of probability sensitivity analysis showed that finerenone combined with the standard treatment regimen was more cost-effective with 100% probability. CONCLUSIONS For DN patients， finerenone combined with the standard treatment regimen is more cost-effective as an absolute advantage option.