高血压电话访问式健康管理模式成本效果分析  

Cost- effectiveness Analysis of Telephone Interview Model of Health Management of Hypertension

作　　者：李文玲[1] 王媛[1] 李文[1] 董燕敏[2] 芦文丽[1] 

机构地区：[1]天津医科大学公共卫生学院流行病与卫生统计学系,天津市300070 [2]天津市社区卫生协会

出　　处：《中国全科医学》2014年第28期3375-3377,共3页Chinese General Practice

基　　金：2012年度中国社区卫生科研基金资助项目(2012-2-25)

摘　　要：目的评估高血压电话访问式健康管理模式在社区人群的成本效果。方法研究设计为社区随机对照试验,2011年10月—2012年12月从天津市友谊社区卫生服务中心高血压管理数据库中按居住区域分层,应用整群抽样的方法抽取240例高血压患者组成研究队列。按随机数字表分配到规范管理组80例、电话访问组80例和对照组80例,比较各组研究前、6个月、1年血压控制率,分析规范化管理和电话访问式健康管理模式的成本效果。结果 3组完成随访的患者的血压控制率比较,差异无统计学意义(P>0.05);不同随访时间血压控制率比较,差异亦无统计学意义(P>0.05)。规范管理组随访满1年的患者血压平均下降7.2 mm Hg,电话访问组血压平均下降5.8 mm Hg。血压每降低1 mm Hg意愿投入4元/人年及以上,电话访问组较规范管理组有效的概率不超过40%。结论电话访问式健康管理模式可以保证较好的血压控制效果,但其成本效果与规范化管理模式差别甚微,未显示出明显优势。Objective To evaluate the cost- effectiveness of telephone interview model of health management of hypertension in community population.Methods A randomized controlled trial was designed.240 patients living in various residential zones were grouped by cluster sampling from a community hospital database in Tianjin and assigned randomly into 3 groups：routine intervention group（ routine group）,telephone delivered intervention group（ Tele- group） and natural control group.Rate of blood pressure control before research,6 months and 1 year after research was compared between groups to analyze the cost- effectiveness of standardized managment and photo interview management.Results The differences of blood pressure control rate for the patients after follow- up in the three groups were insignificant（ P 0.05） and the differences for the patients in various time intervals of follow- up were also insignificant（ P 0.05）.The average blood pressure of patients in routine group who had been followed up for 12 months fell by 7.2 mm Hg while that of Tele- group fell by 5.8 mm Hg.If the cost of decline for 1 mm Hg was 4 yuan RMB or more each person every year,the effective rate of Tele- group was no more than 40% compared with routine group.Conclusion Telephone interview management can guarantee the good effect of blood pressure control but no evidence shows any big differences of cost- effectiveness between standardized management and telephone interview management.Telephone interview management does not show any obvious advantages.

关 键 词：高血压 电话访问 成本效果 慢病管理 

分 类 号：R544.1[医药卫生—心血管疾病]