社区高血压控制效果及其影响因素分析  

Analyzing the Effect of Community-Based Hypertension Prevention and Control and Its Influencing Factors.

作　　者：尤川梅[1] 熊先军 吴月华[3] 熊巨洋[4] 姚岚[4] 

机构地区：[1]中国医学科学院医学信息研究所/卫生政策与管理研究中心,北京100020 [2]中国医疗保险研究协会 [3]南京市卫生局 [4]华中科技大学同济医学院

出　　处：《中国卫生事业管理》2010年第8期513-517,共5页Chinese Health Service Management

基　　金：2009年中国医疗保险协会慢病研究重点项目"城市社区高血压患者就医行为与付方式研究项目"

摘　　要：随着高血压问题日益普遍,实施有效的高血压管理迫在眉睫,而以社区为基础的高血压防治是有效的方式之一。通过高血压患者问卷调查,并辅以定性访谈,本研究发现调研地区在社区开展高血压管理过程中,高血压控制效果受到管理方式、患者的高血压类型和是否有并发症、高血压患者的就医行为和年龄等因素的影响。通过卡方检验和回归分析发现,接受规范化管理、血压级别高和年龄较大的患者,其血压控制效果较好;应就诊而未就诊和应住院而未住院次数越多的患者其血压控制效果越差;而不同并发症对高血压控制效果的影响不一,合并糖尿病的患者其血压控制效果最好,而合并高血脂的患者其血压控制效果较差。因此建议逐步将所有高血压患者纳入规范化管理范围,加强对年轻高血压患者的教育和管理,促使血压级别较低的患者尽早重视高血压防治,重视各类并发症对高血压控制的影响和采取综合措施减少高血压患者应就诊而未就诊和应住院而未住院的情况,以最终提高社区高血压控制的效果。With the increasing prevalence of hypertension, it is imperative to improve effective management. And the community - based hypertension prevention and control is one of the effective methods. By surveying with questionnaires on patients with hypertension in sampling cities, combined with qualitative interviews, factors influencing the effect of hypertension control in communities were obtained, which including management ways, types of hypertension, complications, patients＇ behaviors of visiting doctors and ages. By chi - square test and logistic analysis, better effect of hypertension control was observed in patients as elders, or those who were regularly managed or had severe hypertension. And worse effect was observed in patients who ignoring necessary medical treatment. In addition, different eomplieations had differential influence on hypertension control. Therefore, it is suggested that all the patients should be gradually involved in regular management. Education and management on young patients need to be strengthened. Patients with lower level of hypertension should pay more attention to hypertension prevention and control as soon as possible. Influence of complications on hypertension control should be valued. And other comprehensive measures need to be introduced to increase the effect of community - based hypertension control.

关 键 词：社区 高血压控制 效果 影响因素 

分 类 号：R544.1[医药卫生—心血管疾病]