REVIEW article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1460246
Effectiveness of community health management for hypertensive patients under the medical alliance in China: A systematic review and meta-analysis
Provisionally accepted
- 1Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
- 2Dalian Medical University, Dalian, China
- 3NingboTech University, Ningbo, China
- 4Zhejiang University, Hangzhou, Zhejiang Province, China
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The prevalence of hypertension in China has been increasing, imposing a heavy burden on premature mortality and catastrophic healthcare expenditure. This study aims to evaluate the effectiveness of community health management on blood pressure control for hypertensive patients under the medical alliance, a model of integrated care in China. Methods: Following PRISMA guidelines, three English databases and three Chinese databases were searched from January 2010 to March 2024, with two reviewers involved in the screening, data extraction, quality assessment, and narrative synthesis with characteristics and interventions. Meta-analysis was performed with the value of Hedge's g and 95% confidence interval (CI), using the random-effects model. Subgroup and meta-regression analysis were used to analyze the sources of heterogeneity. Egger's test was applied to detect publication bias. Results: Twenty-five studies covering 7727 hypertensive patients were included, with one of them assessed as low risk of bias. The pooled result showed that compared to conventional community health management, community health management of hypertension under the medical alliance had a more significant effect on reducing systolic blood pressure (Hedge's g: -0.721, 95% CI: -0.890 to -0.552, P<0.001) and diastolic blood pressure (Hedge's g: -0.786, 95% CI: -1.002 to -0.571, P<0.001). It could not be demonstrated that regional distribution, mean age of participants, sample size of the experimental group, sample size of the control group, duration of intervention, and publication year were the sources of heterogeneity. There was a significant publication bias in diastolic blood pressure.This study supports the effectiveness of community health management under the medical alliance in reducing blood pressure for hypertension. The guidance from general hospitals to community health centers, remote monitoring systems to expand the spatial scope of healthcare access and achieve information sharing, and two-way referral are efficient measures in the medical alliance.
Keywords: Integrated healthcare, Medical alliance, Community Health Management, Hypertension, primary healthcare
Received: 05 Jul 2024; Accepted: 22 Apr 2025.
Copyright: © 2025 Gu, Wang, He and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chang-Hai Tang, NingboTech University, Ningbo, China
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