Evaluating the degree of coordination in hypertension medications across primary healthcare institutions, secondary hospitals, and tertiary hospitals in Shanghai, China

Objectives: Hypertension is prevalent worldwide. The accessibility of hypertension medications is one of the crucial factors associated with the control of hypertension. To improve the accessibility of medications, the Chinese government enhances coordination in medication utilization across different levels of hospitals through the national essential medicine system. This study aimed to evaluate the degree of coordination in hypertension medication across various levels of hospitals in Shanghai.
Methods: The study data were sourced from the Shanghai Medication Utilization Monitoring data in 2021. Based on the defined daily doses (DDDs) and defined daily dose consumption (DDDc) of hypertension medications, the degree of coordination in hypertension medication utilization was measured using the Pearson correlation coefficient. Furthermore, the coupling coordination method was utilized to verify the results. Data analysis was conducted using R 4.0 and Microsoft Excel.
Results: The study included 371 hospitals, comprising 232 primary healthcare institutions, 89 secondary hospitals, and 50 tertiary hospitals. It involved a total of 143 hypertension medications, with 124 types available in tertiary hospitals, 122 in secondary hospitals, and 120 in primary healthcare institutions. The Pearson correlation analysis indicated that the correlation coefficient between primary and secondary levels was 0.87; between primary and tertiary levels was 0.31; and between secondary and tertiary levels was 0.69. The findings on coupling coordination showed similar results.
Conclusions: There is a relatively high level of coordination in hypertension medications between primary healthcare institutions and secondary hospitals, as well as between secondary and tertiary hospitals in Shanghai. However, the degree of coordination between primary healthcare institutions and tertiary hospitals is relatively low. It is important to improve the coordination of hypertension medication between primary healthcare institutions and tertiary hospitals.