Core Viewpoint - The implementation of the National Basic Public Health Service Project in Jiangsu has significantly improved public health services over the past 15 years, transitioning from a disease-centered approach to a health-centered model, enhancing the overall health of residents [1][2]. Funding and Financial Support - By 2025, the per capita basic public health funding in Jiangsu has reached 108 yuan, exceeding the national standard, with a mechanism established for seasonal pre-allocation and year-end assessment to ensure precise fund allocation [3]. Service Quality Improvement - Jiangsu has expanded its basic public health services to include 12 categories, such as health records, health education, and chronic disease management, with over 90% of residents having electronic health records by 2024 [4][6]. - The management of chronic diseases has evolved to include multiple conditions, with services like hypertension and diabetes management being integrated into a comprehensive screening and prevention center [4][5]. Community Health Initiatives - Local health workers, such as village doctors, are actively involved in managing residents' health, conducting free health check-ups, and establishing personalized health records for chronic disease management [2][4]. - Innovative services like digital vaccination management and personalized exercise prescriptions are being introduced to enhance community health engagement [6][8]. Future Directions - Jiangsu plans to focus on deepening the integration of medical and preventive services, enhancing digital capabilities, and providing targeted services for specific populations, particularly the elderly and children, to meet the evolving health needs of residents [8].

Core Insights - The article highlights the significant "cascade decrement" issue in the management of chronic diseases such as hypertension and diabetes in rural areas of China, where patients progressively drop out during screening, diagnosis, and control processes [1][2] Group 1: Research Findings - A study conducted by teams from Peking Union Medical College and Nanchang University involved surveys of 7,488 villagers aged 35 to 74 in rural areas of Shandong, Henan, and Wugang, revealing a large population of patients with hypertension and diabetes facing severe management issues [1] - The research indicates that there is a serious disconnect in the management chain for these chronic diseases, leading to patient attrition [1] Group 2: Recommendations for Improvement - To facilitate chronic disease management for rural patients, it is essential to establish a "cognitive staircase" to improve awareness, as many patients lack proper understanding of their conditions [2] - Strengthening the capabilities of grassroots healthcare facilities through skill training, equipment provision, and ensuring follow-up care is crucial for building a solid service foundation [2] - Implementing digital tools such as electronic health records, remote monitoring devices, and mobile health technologies can provide continuous and standardized care for chronic disease patients without requiring hospital visits [2] Group 3: Future Directions - The research team plans to conduct pilot interventions based on identified key points and weaknesses in chronic disease management, focusing on health education, enhancing grassroots service capabilities, and promoting the use of electronic health tools [2] - The study aims to contribute to improving chronic disease management in rural areas and explore practical paths, strategies, and effective interventions [2]