Prevalence of Hypertension and Medical Services Access among Working Age Groups under Social Security Insurance in Nakhon Ratchasima Province 2018

Abstract

The purpose of this cross-sectional study was to investigate prevalence of hypertension by American Heart Association 2017’s new diagnostic criteria and analyzed of medical services access by qualitative research. The samples in the quantitative study were selected by purposive sampling with 6,657 employees and collected 6,033 employees (90.6%) from 4 factory under social security insurance in Nakhon Ratchasima Province, Thailand, between May 1 and July 31, 2018. The descriptive statistics were used in data analyze. The samples in the qualitative study were divided into 4 groups, including representatives of the employees who had been diagnosed with hypertension but not treated continuously for 10 people, The employees who had been diagnosed with hypertension but not continuation in medication of 10 people, The personnel manager and safety officer in each the factory 2 people including  8 people, The manager and staff responsible for the health management in each the hospital 2 people including 4 people were conducted by In-depth interview and analyze data by content analysis. The Results of prevalence of hypertension in working age group under social security insurance in Nakhon Ratchasima Province, found that the new diagnostic criteria (130/80 mmHg) had been a prevalence of 49.3 %, and the traditional criteria (140/90 mmHg) founded the prevalence was 11.6 %, there are lower than the national prevalence (24.7%). The proportion in males is higher than females, there are corresponding to the national data. For medical services access and take medication continuous according to definition of hypertension, there are only 3.7 %. Therefore, Adjustment the diagnosis criteria of hypertension is faster, lead to process of treatment and reduce the complications of hypertension, may not be based on such objectives. It is necessary to develop medical services in accordance with the context of the establishment and the working time of health personnel. In addition, the use of financial mechanisms encourages medical services units to provide proactive services in the workplace, include improved the law and welfare regulations to allow employees to take sick leave in chronic disease at least once a month by not counted as leave days and should enhance communication channels for the laborers to be aware and to focus on continuous medical treatment.