Objective: To establish a hypertension risk assessment model among the middle-aged and elderly populations based on residents' electronic healthcare records of the basic public health service program, so as to provide insights into prevention of hypertension. Methods: Demographic features and physical examinations were collected among residents at ages of 40 years and older from residents' electronic healthcare records of the basic public health service program in a county of Zhejiang Province from 2019 to 2020. The risk factors of hypertension were identified using a multivariable logistic regression model, and the odds ratio (OR) for each risk factor was transformed into approximate relative risk (RR), which was included in the formula for calculation of the disease risk proposed by Harvard School of Public Health to create a hypertension risk assessment model. The predictive value of the model was evaluated using a receiver operator characteristic (ROC) curve. Results: Totally 7 275 subjects were enrolled, with a mean age of (66.15±7.91) years, and the participants included 3 189 males and 4 086 females, with a male-to-female ratio of 0.78∶1. There were 190 cases with new-onset hypertension (2.61%). Multivariable logistic regression analysis revealed that overweight, obesity, central obesity, borderline high triacylglycerol (TG), elevated TG, abnormal fasting plasma glucose (FPG), prehypertension and family history of hypertension were included in the hypertension risk assessment model, with approximate RR values of 1.66, 1.96, 1.54, 1.17, 1.64, 1.45, 1.69 and 1.11. The area under the ROC curve (AUC) of the model was 0.678 (95%CI: 0.641-0.715, P<0.001), and the optimal positive cut-off was 0.899. The model predicted 139 subjects with RR>0.899 for hypertension, with a sensitivity of 73.16% and specificity of 55.79%. Conclusions The hypertension risk assessment model created in this study is feasible to predict the RR for developing hypertension among the middle-aged and elderly populations, which has a predictive value in healthcare management.

Objective: To investigate and analyze the awareness, utilization, and satisfaction of patients with chronic diseases (hypertension and type 2 diabetes mellitus), as well as the influencing factors related to health management services for chronic diseases in basic public health service projects in Zhejiang Province, in order to promote the development of effective health management services for chronic diseases. Methods: Between September and November 2017, 960 local patients with chronic diseases aged 35 years or older were randomly selected in eight counties (cities/districts) in Zhejiang province using the random number table, based on the chronic disease information from the information management system. A total of 394 (41.04%) male and 566 (58.96%) female patients, with an average age of (68.02±10.02) years, participated in this study. Face-to-face questionnaires were used to collect patients’ awareness, utilization, and satisfaction with health management services for chronic diseases. The awareness of health management services for chronic diseases and their utilization status were described and analyzed by statistical rate indicators. Possible factors affecting the awareness and utilization status were analyzed by χ² test and logistic regression. Satisfaction scores of patients with chronic diseases were analyzed by means and standard deviation. T-test was used to compare the satisfaction level with service items (service convenience, service environment, waiting time, medical skill level, and service attitude) between urban and rural patients with chronic diseases. Finally, multivariate logistic regression analysis was conducted to determine overall satisfaction. Results: The overall awareness of health management services for chronic diseases in chronic disease patients was 96.15%. Multivariate Logistic regression analysis showed that patients who lived in developed regions, rural areas, and patients who did not live alone had more awareness of health management services (OR= 0.347, 3.563, and 0.281, all P <0.05). The overall utilization rate of health management services for chronic diseases in chronic disease patients was 94.58%. Multivariate Logistic regression analysis revealed that patients who lived in developed regions and rural areas showed better utilization of health management services (OR= 0.297 and 4.145, all P<0.05). The average satisfaction score of patients for all items of health management services was above nine. The satisfaction scores of chronic disease patients in rural areas regarding service convenience, service environment, waiting time, and service attitude were better than those of chronic disease patients in urban areas (t=-2.157, -3.614, -3.164, -2.879, all P<0.05). The overall satisfaction score regarding health management services for chronic diseases was 92.95%. Multivariate Logistic regression analysis showed that patients who purchased health insurance for urban and rural residents reported higher overall satisfaction with health management services for chronic diseases compared to those patients who purchase other medical insurance (OR=2.943, P<0.05). Conclusion The current level of awareness, utilization, and satisfaction with health management services for chronic diseases among chronic disease patients in Zhejiang province should be further improved. Moreover, attention should be paid to the balanced development of urban and rural areas to further increase the equality level of basic public health services.

Objective To explore the financial compensation strategy on the basis of understanding the current situation of compensation for public health services at public hospitals in Zhejiang province.Methods From July to October,2017,an interview survey was conducted at 23 public hospitals in 7 cities in Zhejiang province to understand the current situation of financial compensation for public health services at public hospitals.At the same time,the data of income and expenditure in 2016 of every hospital were collected and analyzed by the methods of descriptive statistics.Results The average proportion of financial subsidies at the 23 public hospitals in 2016 was 6.29％,of which public health special subsidy accounted for 0.44％ of total hospital revenues.Only 9 of the 23 hospitals had surplus in 2016,accounting for 39.13％.Conclusions The public health services compensation mechanism of public hospitals in Zhejiang province calls for further reforms.The government departments should comprehensively formulate financial compensation policies at the provincial level according to the public health assignments and call into play a variety of compensation methods,to establish a long-term assessment mechanism and ensure that public hospitals can proactively carry out public health services.