上海社区家庭医生服务模式对高血压管理效果的影响  

Influence of Family Doctor System on Management effect of Patients with Hypertension in community

作　　者：俞李萍 赵志勇[2] 张金玲[3] 张瑞凤 俞能年[4] 赵黎芳[3] 

机构地区：[1]上海市闵行区梅陇社区卫生服务中心,上海201100 [2]江苏省常州市武进人民医院,江苏常州213017 [3]上海市闵行区疾病预防控制中心,上海201101 [4]上海市浦南医院,上海200125

出　　处：《吉林医学》2016年第3期592-594,共3页Jilin Medical Journal

摘　　要：目的：分析社区GP服务模式对高血压管理效果的影响。方法：通过前瞻性实验性研究方法,随机选取高血压新发患者272例作为试验组,同时选择88例高血压患者作为对照组。对照组采用常规的高血压诊疗措施进行降压治疗,试验组在对照组的基础上,采用社区GP服务模式对高血压患者进行干预和管理收集患者血压、管理依从性、健康行为、满意度等资料,随访一年后对管理效果进行比较分析。结果：患者收缩压和舒张压均降低明显优于对照组（P〈0.001）。患者规律用药、饮食食盐控制、蔬菜水果的摄入的增加以及患者对医务人员的满意度与对照组比较均有所增加,RR分别为2.17（95%CI：1.04~4.40）、4.57（95%CI：2.34~8.88）、1.77（95%CI：1.03~3.00）和2.30（95%CI：1.08~4.78）。吸烟率下降,RR=0.55,95%CI：0.33~0.93。结论：上海社区GP服务模式促进了高血压管理效果,值得在社区推广应用。Objective To analysis the effect of family doctor system on management of patients with hypertension. Method Totally 360 patients with hypertension recruited by random sampling in Meilong communities were randomly divided into control group（ n = 88） and trial group（ n = 272）. Control group and trial group matched with gender,age and blood pressure. Patients in the control group were managed with the traditional management modes,while patients in the trial group were managed with family doctor system. The data of patients＇ blood pressure,compliance management,healthy behavior and the satisfaction degree between the two groups were collected and compared. Results After intervention with 1 year,the blood pressure of all groups decreased,with the decline of blood pressure different statistically significant（ P〈0. 001）. The rate of regular taking medicine,salt control in food and drink,decline of smoking,and increasing of vegetable and fruit amount were all of significant difference,with RR（ 95% CI） of 2. 17（ 1. 04 ~ 4. 40）,4. 57（ 2. 34 ~ 8. 88）,0. 55（ 0. 33 ~ 0. 93）,1. 77（ 1. 03 ~ 3. 00） and 2. 30（ 1. 08 ~ 4. 78） respectively. Conclusion The service mode of family doctor system can remarkably raise the effectiveness of management for patients with hypertension.

关 键 词：家庭医生制 高血压 管理效果 影响 

分 类 号：R544.1[医药卫生—心血管疾病]