Standardized chronic disease management reduces comorbidity risk in China

Non-communicable chronic diseases pose a significant public health challenge worldwide. China has launched a nationwide standardized Chronic Disease Patient Management program to provide primary care for patients with hypertension and type 2 diabetes, but its effect on reducing risks of other chronic diseases remains unclear. Here we show, using linked health profiles and medical records from 26 million residents in Shenzhen, China, that program enrollment is associated with lower comorbidity risk among 701,759 patients with newly diagnosed hypertension and 320,179 patients with newly diagnosed type 2 diabetes between 2017 and 2023. Instrumental variable analyses indicate that enrollment reduces overall comorbidity risk by 9% and 14%, respectively. Participants show lower risks for more than 20 chronic diseases. Intervention-specific analyses reveal heterogeneous effects, with alcohol-use, medication-adherence, and psychological support interventions reducing risks of multiple chronic diseases in both patient groups, whereas smoking cessation intervention shows more complex risk patterns among patients with hypertension. These findings support standardized chronic disease management for reducing comorbidity risk and highlight the need for personalized follow-up.