Abstract: Background　While many studies have focused on the hospitalization costs of hypertensive patients，few have examined avoidable hospitalization in hypertensive patients using big data. Objective　This study aims to assess the prevalence of avoidable hospitalization among elderly hypertensive patients in Guangdong Province，providing insights for the integration and optimization of healthcare resources in the province's medical communities. Methods　Health data for elderly individuals in Guangdong and hospitalization records from 2022 were integrated using the Guangdong Province Primary Healthcare Information Management System，the Guangdong Province Universal Health Information Platform，and inpatient case data. Influencing factors such as the number of general practitioners（GPs）per 10 000 population and the number of visits to primary healthcare institutions were obtained from the 2022 Guangdong Provincial Health Statistics Yearbook. A Logistic regression model was used to analyze the factors contributing to avoidable hospitalization. Results　The rate of avoidable hospitalization among elderly hypertensive patients in Guangdong Province was 8.76%. The likelihood of avoidable hospitalization was significantly higher in females ［OR（95%CI）=1.231（1.217，1.246）］ compared to males. Using 90 years and older as a reference， hypertensive patients aged 65-69，70-74，75-79，and 80-84 years were 2.044 ［OR（95%CI）=2.044（1.981，2.109）］， and 1.640 times more likely to avoid the occurrence of hospitalization than older hypertensive patients aged 90 years and older， respectively ［OR（95%CI）=1.640（1.590，1.693）］，1.288 times ［OR（95%CI）=1.288（1.248，1.329）］，and 1.110 times ［OR（95%CI）=1.110（1.073，1.147）］. Using a GDP per capita of less than 100 000 yuan as a reference， hypertensive patients with a GDP per capita of 100 000 yuan and above were 1.314 times more likely to have an avoidable incidence of hospitalization than those with a GDP per capita of less than 100 000 yuan ［OR（95%CI）=1.314（1.278，1.350）］. When the number of GPs was ≥ 4 per 10 000 population，hypertensive patients were 1.039 times more likely to have avoidable hospitalization compared to those in areas with fewer than 4 GPs per 10，000 population ［OR（95%CI）=1.039（1.105，1.063）］. The probability of avoidable hospitalization decreased by 40.60% when the number of secondary and tertiary hospitals per 10 000 population was less than 0.20 ［OR（95%CI）=0.594（0.570，0.619）］. Finally，compared to areas with fewer than 3 visits per capita to secondary and tertiary hospitals or grassroots institutions，those with ≥ 3 visits per capita had a 1.047 times higher probability of avoidable hospitalization in secondary and tertiary hospitals ［OR（95%CI）=1.047（1.021，1.074）］，and a 1.229 times higher probability in grassroots institutions ［OR（95%CI）=1.229（1.191，1.268）］. Conclusion　Gender and age are significant factors influencing avoidable hospitalization in elderly hypertensive patients. Higher GDP per capita，greater visit frequency，and more GPs were associated with increased likelihood of avoidable hospitalization，while the number of secondary and tertiary hospitals did not contribute to this risk.

Key words: Hypertension, Aged, Avoidable hospitalization, Root cause analysis, Guangdong province

摘要： 背景　目前对高血压患者住院费用开展的研究较多，但少有学者基于大数据开展高血压患者可避免住院的相关研究。目的　了解广东省老年高血压患者可避免住院现状，为我省紧密型医共体整合优化医疗卫生资源提供参考。方法　通过广东省基层医疗卫生信息管理系统、广东省全民健康信息平台、住院病案首页数据等集成获取全省65岁及以上老年人健康信息及2022年住院信息，人均GDP、全科医生、在职职工等数据来自2022广东省卫生健康统计年鉴、广东统计年鉴2022年，以地市为单位将统计年鉴的数据匹配到个案中。采用Logistic回归分析探讨老年高血压患者可避免住院的影响因素。结果　广东省老年高血压患者可避免住院率为8.76%，老年女性高血压患者可避免住院发生的可能性较男性更大［OR（95%CI）=1.231（1.217，1.246）］，65~69岁、70~74岁、75~79岁、80~84岁的高血压患者可避免住院的可能性分别是90岁老年高血压患者的2.044倍［OR（95%CI）=2.044（1.981，2.109）］、1.640倍［OR（95%CI）=1.640（1.590，1.693）］、1.288倍［OR（95%CI）=1.288（1.248，1.329）］、1.110倍［OR（95%CI）=1.110（1.073，1.147）］，人均GDP在10万元及以上的高血压患者可避免住院发生的可能性是人均GDP低于10万元的1.314倍［OR（95%CI）=1.314（1.278，1.350）］，全科医生数≥4人/万人口时高血压患者可避免住院的可能性是低于4人/万人口的1.039倍［OR（95%CI）=1.039（1.105，1.063）］；二三级医院拥有量≥0.20/万人口时，高血压患者可避免住院发生的可能性将降低40.60%［OR（95%CI）=0.594（0.570，0.619）］；二三级医院就诊人次数≥3时，高血压患者可避免住院的可能性是二三级医院人均就诊人次数﹤3的1.047倍［OR（95%CI）=1.047（1.021，1.074）］；当基层机构人均就诊人次数≥3人次时，高血压患者可避免住院的可能性是人均就诊人次数﹤3人次的1.229倍［OR（95%CI）=1.229（1.191，1.268）］。结论　性别、年龄等为老年高血压患者可避免住院的影响因素。人均GDP水平越高、就诊次数越多、全科医生数量越多，可避免住院发生的可能性增大。二三级医院数量的增加，未增加可避免住院发生的风险。

关键词: 高血压, 老年人, 可避免住院, 影响因素分析, 广东省