Analysis of types and medication of common chronic diseases in the elderly visiting primary medical institutions in eight provinces and cities

Abstract

Objective To investigate the types of common chronic diseases and common drugs in the elderly visiting primary medical institutions in China. Methods Cluster sampling was adopted in eight provinces/cities/autonomous region of Zhejiang, Jilin, Henan, Shanghai, Chongqing, Gansu, Guangxi and Jiangsu.Sampling sites were selected and information was collected through the online reporting system of common diseases and drug costs of the elderly in primary hospitals at all levels in China.On these grounds, the basic situation of primary medical institutions, the common chronic diseases and common drugs for people aged 65 years and above were investigated. Results Primary hypertension(65.7% or 46/70)and arthropathy(10.0% or 7/70)were the most common chronic diseases in the elderly visiting primary medical institutions.The consultation rate of primary hypertension was highest both in rural areas(58.3%, i.e.the ratio of 21 over 36 primary medical institutions)and in urban areas(73.5%, i.e.the ratio of 25 over 34 primary medical institutions). The primary medical institutions with consultation rates of hypercholesterolemia/hyperlipidemia(χ2=5.137, P=0.023), diabetes(χ2=3.868, P=0.049)and dyspepsia(Fisher's exact test, P=0.026)as the top 3 chronic diseases were more often seen in urban areas than in rural areas, while the primary medical institutions with consultation rates of cerebrovascular diseases as the top 3 chronic diseases were more often seen in the rural areas than in urban areas(χ2=9.974, P=0.002). More primary medical institutions with consultation rates of benign prostatic hyperplasia and primary osteoporosis as the top 10 chronic diseases were found in urban areas than in rural areas(χ2=4.054 and 3.861, P=0.044 and 0.049, respectively), while more primary medical institutions with consultation rates of heart failure as the top 10 chronic diseases were found in rural areas than in urban areas(χ2=3.865, P=0.049). Aspirin, nifedipine and simvastatin one by one were most commonly used in people aged 65 years and over in primary medical institutions. Conclusions Primary hypertension is the most common chronic disease among the elderly visiting primary medical institutions in both rural and urban.Common chronic diseases in primary medical institutions are different between the urban and rural areas.Regional differences and urban-rural differences should be taken into account in drug preparation.There are some irregularities in the use of drugs and insufficient stocks of essential drugs in basic-level medical institutions. Key words: Primary medical institutions; Essential drugs; Chronic disease