社区慢性心力衰竭患者就医特点浅析  

Health seeking behavior of patients with chronic heart failure in community

作　　者：王桂莲[1] 李瑞杰[1] 杨坚[1] 郭凤山 

机构地区：[1]北京市朝阳区第二医院重症监护室,100026

出　　处：《中华全科医师杂志》2015年第8期632-635,共4页Chinese Journal of General Practitioners

基　　金：北京市朝阳区科技计划(社会发展计划)

摘　　要：采用整群抽样方法抽取10个社区60岁以上老人1 500名进行问卷调查和体格检查,结果检出心力衰竭（心衰）患者65人.回收的心衰患者问卷显示其中77.6％（38/49）在三级医院确诊,远高于社区医院（12.2％,6/49）;心衰发作时,选择直接打车去三级医院的患者最多（37.7％,20/53）,和社区医生联系的患者较少（17.0％,9/53）;心衰发作后,有68.8％ （33/48）的患者可以在30 min内到达医院,55.3％（26/47）的患者可以在60 min内获得治疗;45.7％（21/46）的老年心衰患者每年因心衰住院1次,31.1％ （14/45）的患者每次因心衰住院时间小于10 d,出院后接受过健康教育的占46.0％（23/50）,接受过用药监督的占40.0％ （16/40）,健康教育者主要为社区医生,主要监督者为家庭成员.提示心衰的确诊和治疗仍依赖于二级医院,社区卫生机构在老年心衰患者院外健康教育和管理中发挥着重要作用,但目前心衰管理对社区卫生服务的利用度仍然较低.Total 1 500 subjects aged over 60 years were selected from 10 community health service centers with cluster sampling method.A questionnaire survey and physical examination were performed in all subjects.Sixty five patients with chronic heart failure were detected.The questionnaire showed that 77.6％ （38/49）patients were diagnosed in tertiary hospitals,and 12.2％ （6/49） were diagnosed in community hospitals.When heart failure occurred,most patients （37.7％,20/53） chose to take a taxi to the tertiary hospital directly,and less patients （17.0％,9/53）contacted community doctors.When a heart attack happened,68.8％ （33/48）of the patients could reach the hospital within 30 min,and 55.3％ （26/47） within 60 min.45.7％ （21/46） elderly patients were hospitalized for heart failure once a year;31.1％ （14/45） were in hospital for less than 10 d each time.46.0％ （23/50） heart failure patients had received health education and 40.0％ （16/40） had taken drugs under supervision;the majority health educators were community doctors and majority supervisors were family members.The results suggest that the confirmed diagnosis and treatment of heart failure patients still rely on tertiary hospitals,community health institutions play an important role in health education and management of heart failure patients outside hospitals.But the utilization of community health services is still not enough in community health service centers.

关 键 词：疾病管理 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]