2024
Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial
Song J, Wang X, Wang B, Ge Y, Bi L, Jing F, Jin H, Li T, Gu B, Wang L, Hao J, Zhao Y, Liu J, Zhang H, Li X, Li J, Ma W, Wang J, Normand S, Herrin J, Armitage J, Krumholz H, Zheng X. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial. The BMJ 2024, 386: e079143. PMID: 39043397, PMCID: PMC11265211, DOI: 10.1136/bmj-2023-079143.Peer-Reviewed Original ResearchConceptsClinical decision support systemsPrimary care practicesElectronic health recordsIntervention groupSystolic blood pressurePrimary careCare practicesBlood pressure <Health recordsPragmatic cluster randomised controlled trialCluster randomised controlled trialImproving hypertension treatmentPrimary care settingBlood pressure control ratesBlood pressureProportion of visitsProportion of participantsRandomised controlled trialsSystolic blood pressure <Control groupInjurious fallsRelated visitsCare settingsDiastolic blood pressure <Follow-up
2023
Primary care institutional characteristics associated with hypertension awareness, treatment, and control in the China PEACE-Million Persons Project and primary health-care survey: a cross-sectional study
Group C, Zhou T, Wang Y, Zhang H, Wu C, Tian N, Cui J, Bai X, Yang Y, Zhang X, Lu Y, Spatz E, Ross J, Krumholz H, Lu J, Li X, Hu S. Primary care institutional characteristics associated with hypertension awareness, treatment, and control in the China PEACE-Million Persons Project and primary health-care survey: a cross-sectional study. The Lancet Global Health 2023, 11: e83-e94. PMID: 36521957, DOI: 10.1016/s2214-109x(22)00428-4.Peer-Reviewed Original ResearchMeSH KeywordsAntihypertensive AgentsChinaCross-Sectional StudiesHumansHypertensionPrimary Health CareConceptsProportion of participantsPrimary care institutionsHypertension awarenessPrimary care systemBlood pressureCare institutionsCardiac Events Million Persons ProjectAverage diastolic blood pressureMedical Sciences (CAMS) Innovation FundAverage systolic blood pressureCare systemMillion Persons ProjectHistory of hypertensionDiastolic blood pressurePrimary care surveySystolic blood pressureCardiovascular disease riskBlood pressure measurementsCross-sectional studyParticipant-level dataProportion of physiciansRoutine service deliveryPrimary care roleHealth Care SurveyPublic health services
2022
Effectiveness of a clinical decision support system for hypertension management in primary care: study protocol for a pragmatic cluster-randomized controlled trial
Song J, Wang X, Wang B, Gao Y, Liu J, Zhang H, Li X, Li J, Wang JG, Cai J, Herrin J, Armitage J, Krumholz HM, Zheng X. Effectiveness of a clinical decision support system for hypertension management in primary care: study protocol for a pragmatic cluster-randomized controlled trial. Trials 2022, 23: 412. PMID: 35578345, PMCID: PMC9109449, DOI: 10.1186/s13063-022-06374-x.Peer-Reviewed Original ResearchMeSH KeywordsAntihypertensive AgentsBlood PressureDecision Support Systems, ClinicalHumansHypertensionPrimary Health CareRandomized Controlled Trials as TopicConceptsHypertension managementPrimary carePrimary outcomeDual antihypertensive therapyHypertension Treatment TrialBlood pressure managementGuideline-based treatmentPrimary care sitesCluster-randomized trialUnit of randomizationGuideline-based decision support systemClinical decision support systemAntihypertensive regimensAntihypertensive treatmentUsual careGuideline adherenceBlood pressureMiddle-income countriesTreatment trialsManagement visitsStudy protocolCare sitesPatientsTrialsPressure management
2021
Prevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China
Lu Y, Zhang H, Lu J, Ding Q, Li X, Wang X, Sun D, Tan L, Mu L, Liu J, Feng F, Yang H, Zhao H, Schulz WL, Krumholz HM, Pan X, Li J, Huang C, Dong Z, Jiang B, Guo Z, Zhang Y, Sun J, Liu Y, Ren Z, Meng Y, Wang Z, Xi Y, Xing L, Tian Y, Liu J, Fu Y, Liu T, Sun W, Yan S, Jin L, Zheng Y, Wang J, Yan J, Xu X, Chen Y, Xing X, Zhang L, Zhong W, Fang X, Zhu L, Xu Y, Guo X, Xu C, Zhou G, Fan L, Qi M, Zhu S, Qi J, Li J, Yin L, Liu Q, Geng Q, Feng Y, Wang J, Wen H, Han X, Liu P, Ding X, Xu J, Deng Y, He J, Liu G, Jiang C, Zha S, Yang C, Bai G, Yu Y, Tashi Z, Qiu L, Hu Z, He H, Zhang J, Zhou M, Li X, Zhao J, Ma S, Ma Y, Huang Y, Zhang Y, Li F, Shen J. Prevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China. JAMA Network Open 2021, 4: e2127573. PMID: 34586366, PMCID: PMC8482054, DOI: 10.1001/jamanetworkopen.2021.27573.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseLipid-lowering medicationsPrimary care institutionsPrevalence of dyslipidemiaControl of dyslipidemiaLipoprotein cholesterolCare institutionsControl rateFemale sexCardiovascular diseaseMAIN OUTCOMEHigh riskNonstatin lipid-lowering drugsHigh-density lipoprotein cholesterolLow-density lipoprotein cholesterolPrimary health care settingsMajor public health problemLipid lowering medicationsMillion Persons ProjectOverall control rateLDL-C levelsLipid-lowering drugsCross-sectional studyPublic health problemHealth care settings
2020
Quality of primary health care in China: challenges and recommendations
Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, Mossialos E, Li C, Lu J, Su M, Zhang Q, Xu DR, Li L, Normand ST, Peto R, Li J, Wang Z, Yan H, Gao R, Chunharas S, Gao X, Guerra R, Ji H, Ke Y, Pan Z, Wu X, Xiao S, Xie X, Zhang Y, Zhu J, Zhu S, Hu S. Quality of primary health care in China: challenges and recommendations. The Lancet 2020, 395: 1802-1812. PMID: 32505251, PMCID: PMC7272159, DOI: 10.1016/s0140-6736(20)30122-7.Peer-Reviewed Original ResearchConceptsPrimary health care systemHealth care systemPrimary health carePublic health servicesClinical careHealth servicesPrimary health care physiciansPrimary health care practitionersPrimary health care institutionsBasic public health servicesHealth care physiciansHealth careCoronavirus disease 2019Entire health care systemHealth care practitionersHigh-value careLearning health systemChronic diseasesDisease 2019Health care institutionsInfectious diseasesHealth systemCare systemCareSuboptimal education
2017
The primary health-care system in China
Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q, Mossialos E, Xu DR, Yip W, Zhang H, Krumholz HM, Jiang L, Hu S. The primary health-care system in China. The Lancet 2017, 390: 2584-2594. PMID: 29231837, DOI: 10.1016/s0140-6736(17)33109-4.Peer-Reviewed Original ResearchMeSH KeywordsChinaHealthcare FinancingHumansInsurance, HealthMedical InformaticsPrimary Health CareQuality of Health CareWorkforceConceptsPrimary health care systemHealth care systemChronic non-communicable diseasesEvidence-based performance indicatorsNon-communicable diseasesEveryday clinical practiceQuality of careHealth information technology systemsRisk factorsClinical practiceCare deliveryVillage doctorsHealth care reformInadequate educationCost savingsWorld populationPopulationPrevalenceDiseaseAvailability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey
Su M, Zhang Q, Bai X, Wu C, Li Y, Mossialos E, Mensah GA, Masoudi FA, Lu J, Li X, Salas-Vega S, Zhang A, Lu Y, Nasir K, Krumholz HM, Jiang L. Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey. The Lancet 2017, 390: 2559-2568. PMID: 29102087, DOI: 10.1016/s0140-6736(17)32476-5.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntihypertensive AgentsChinaCross-Sectional StudiesDrug CostsFemaleHumansMaleMiddle AgedPractice Patterns, Physicians'Primary Health CareConceptsPrimary health care sitesNationwide cross-sectional surveyAntihypertensive medicationsPrimary health carePrescription patternsCross-sectional surveyHealth care sitesHealth centersVillage clinicsPrimary health care providersCommunity health stationsBurden of hypertensionCommunity health centersHealth careCAMS Innovation FundHealth care providersHigh-cost medicationsTownship health centersBlood pressureFamily Planning CommissionMedication costsAffordable medicationsNational HealthHealth stationsMedicationsProtocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey
Su M, Zhang Q, Lu J, Li X, Tian N, Wang Y, Yip W, Cheng KK, Mensah GA, Horwitz RI, Mossialos E, Krumholz HM, Jiang L. Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey. BMJ Open 2017, 7: e016195. PMID: 28851781, PMCID: PMC5629739, DOI: 10.1136/bmjopen-2017-016195.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedChinaFemaleHealth Care SurveysHumansMaleMiddle AgedPatient SatisfactionPrimary Health CareQuality of Health CareResearch DesignConceptsPrimary health careMillion Persons ProjectQuality of careCardiac Events Million Persons ProjectHealth carePrimary care servicesEssential medicines programmeHealth Care SurveyChina PatientCare SurveyPatient satisfactionPHC servicesPHC workforceCardiovascular diseaseCare servicesObservational designPHC institutionsCentral Ethics CommitteeInformed consentChina National CenterEthics CommitteeCarePerson interviewsMedicine programsNationwide survey
2012
Features of High Quality Discharge Planning for Patients Following Acute Myocardial Infarction
Cherlin EJ, Curry LA, Thompson JW, Greysen SR, Spatz E, Krumholz HM, Bradley EH. Features of High Quality Discharge Planning for Patients Following Acute Myocardial Infarction. Journal Of General Internal Medicine 2012, 28: 436-443. PMID: 23263917, PMCID: PMC3579981, DOI: 10.1007/s11606-012-2234-y.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrimary care physiciansHospital discharge processDischarge planningCare physiciansMyocardial infarctionMedicaid Services Hospital Compare websitePercutaneous coronary interventionPrimary care providersQuality discharge planningHigh quality discharge planningCase management servicesHospital Compare websiteCoronary interventionAMI carePatient hospitalPatient hospitalizationPatient admissionsPatient educationCare plansCare providersMortality ratePatientsEducation sessionsHospital
2011
US Cardiologist Workforce From 1995 To 2007: Modest Growth, Lasting Geographic Maldistribution Especially In Rural Areas
Aneja S, Ross JS, Wang Y, Matsumoto M, Rodgers GP, Bernheim SM, Rathore SS, Krumholz HM. US Cardiologist Workforce From 1995 To 2007: Modest Growth, Lasting Geographic Maldistribution Especially In Rural Areas. Health Affairs 2011, 30: 2301-2309. PMID: 22147857, PMCID: PMC3332098, DOI: 10.1377/hlthaff.2011.0255.Peer-Reviewed Original ResearchConceptsPrimary care physiciansCare physiciansGeographic maldistributionChronic cardiovascular diseaseHospital referral regionsUse of telemedicineCardiology workforceNumber of cardiologistsTotal physician workforceCardiovascular diseaseCardiovascular careReferral regionsElderly populationUS populationTotal physiciansCardiologistsPhysiciansAge sixtyPhysician workforceDisadvantaged areasPercentRural areasPopulationDiseaseVariety of strategies
2008
Dual Use of Veterans Affairs Services and Use of Recommended Ambulatory Care
Ross JS, Keyhani S, Keenan PS, Bernheim SM, Penrod JD, Boockvar KS, Krumholz HM, Siu AL. Dual Use of Veterans Affairs Services and Use of Recommended Ambulatory Care. Medical Care 2008, 46: 309-316. PMID: 18388846, DOI: 10.1097/mlr.0b013e31815b9db3.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAmbulatory CareBehavioral Risk Factor Surveillance SystemCross-Sectional StudiesFemaleHealth Services AccessibilityHumansMaleMiddle AgedPrimary Health CareQuality Indicators, Health CareQuality of Health CareSocioeconomic FactorsUnited StatesUnited States Department of Veterans AffairsConceptsVA usersPatient characteristicsCancer screeningDual usersVeterans Affairs Medical SystemBehavior Risk Factor Surveillance SystemRisk Factor Surveillance SystemCardiovascular risk reductionMultivariable logistic regressionProstate cancer screeningAmbulatory care servicesVeterans Affairs servicesCommunity-dwelling adultsBreast cancer screeningLow useCross-sectional analysisInfectious disease preventionHealth care systemInfluenza vaccinationCare patientsSelf-reported useUnadjusted analysesCancer preventionOutcome measuresAmbulatory care
2007
Guideline recommendations and results: the importance of the linkage.
Krumholz HM. Guideline recommendations and results: the importance of the linkage. Annals Of Internal Medicine 2007, 147: 342-3. PMID: 17785490, DOI: 10.7326/0003-4819-147-5-200709040-00010.Peer-Reviewed Original Research