Stroke incidence trends and the role of chronic disease management in a universal health coverage system: a retrospective observational study in Macao, 2019-2024.
KH, T., HW, C., WY, K., SK, L., W, Z., & I, W. (2026). Stroke incidence trends and the role of chronic disease management in a universal health coverage system: a retrospective observational study in Macao, 2019-2024.. Family medicine and community health. https://doi.org/10.1136/fmch-2026-004068
KH T, HW C, WY K, SK L, W Z, I W. Stroke incidence trends and the role of chronic disease management in a universal health coverage system: a retrospective observational study in Macao, 2019-2024.. Family medicine and community health. 2026; doi: 10.1136/fmch-2026-004068
KH T, HW C, WY K, et al. Stroke incidence trends and the role of chronic disease management in a universal health coverage system: a retrospective observational study in Macao, 2019-2024.[J]. Family medicine and community health. 2026. DOI: 10.1136/fmch-2026-004068.
@article{kh2026,
author = {Tam KH and Chou HW and Kwong WY and Lei SK and Zeng W and Wong I},
title = {Stroke incidence trends and the role of chronic disease management in a universal health coverage system: a retrospective observational study in Macao, 2019-2024.},
journal = {Family medicine and community health},
year = {2026},
doi = {10.1136/fmch-2026-004068},
note = {PMID: 42674669},
}
TY - JOUR AU - Tam KH AU - Chou HW AU - Kwong WY AU - Lei SK AU - Zeng W AU - Wong I TI - Stroke incidence trends and the role of chronic disease management in a universal health coverage system: a retrospective observational study in Macao, 2019-2024. T2 - Family medicine and community health PY - 2026 DO - 10.1136/fmch-2026-004068 AN - PMID:42674669 ER -
OBJECTIVE: To analyse the temporal trend of stroke incidence from 2019 to 2024 in Macao and evaluate its relationship with hypertension (HTN) and type 2 diabetes mellitus (T2DM) management within a universal health coverage (UHC) system. DESIGN: Retrospective observational study using routinely collected electronic health records. SETTING: Macao Health Bureau's primary care system, which provides free, publicly funded community health services to all residents. PARTICIPANTS: Macao residents aged ≥15 years with a confirmed diagnosis of ischaemic or haemorrhagic stroke recorded in the Macao Health Bureau medical system between 1 January 2019 and 31 December 2024 (n=8265). RESULTS: Age-standardised stroke incidence declined from 250.03 per 100 000 in 2019 to 219.95 per 100 000 in 2022, followed by a rebound in 2023-2024 which may partly reflect pandemic-related data entry delays. Over 88% of patients with pre-existing HTN or T2DM had documented healthcare follow-up in the year preceding their stroke. Stroke incidence among these high-risk patients declined and the interval from diagnosis to stroke onset lengthened significantly, yet a substantial stroke burden persisted. CONCLUSION: High healthcare engagement was associated with improved risk monitoring and delayed stroke onset. However, the persistent stroke burden suggests that achieving high coverage alone is not sufficient-ongoing quality improvement in chronic disease management is essential to translate engagement into better outcomes.