Trends and interrupted time series analysis of congenital heart disease mortality among the Chinese population aged 0–64 years, 2002–2021

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OBJECTIVES: Our study aimed to analyze congenital heart disease (CHD) mortality trends among Chinese residents aged 0-64 years from 2002 to 2021 and assess the impact of implementing the medical insurance policy (MIP) for rural children on CHD mortality. METHODS: Data on CHD mortality in urban and rural regions of China from 2002 and 2021 were collected from the China Health Statistics Yearbook. Because mortality data for individuals aged ≥65 years were incomplete and lacked specificity for CHD, the analysis was restricted to those aged 0-64 years. Joinpoint regression was used to analyze trends in CHD mortality by region, sex, and age group, and interrupted time series analysis was used to evaluate the impact of the MIP on CHD mortality. RESULTS: Between 2002 and 2021, the standardized CHD mortality among Chinese residents was higher in rural areas than in urban areas, and higher in males than in females. CHD mortality for rural and urban residents declined at an average annual percentage change (AAPC) of -3.63% (95% CI: -4.84% ~ -2.40%) and -4.99% (95% CI: -8.38% ~ -1.47%), respectively. Male mortality decreased more than female mortality. Mortality in the < 1, 1-4, 5-9, 35-39, and 40-44 age groups have been declining over the past 20 years; Furthermore, CHD mortality in rural areas has gradually decreased since the implementation of MIP (β3 = -0.073,95% CI: -0.100 ~ -0.045). CONCLUSIONS: In China, CHD mortality declined from 2002 to 2021, with variations still present based on gender, age, and region. Future prevention and control measures should be strengthened for specific populations in different regions.

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