社区高血压患者血压控制效果的影响因素研究  

Influencing factors of hypertension control for hypertensive patients in community

作　　者：冯芮华[1] 王增武[2] 罗爱静[3] 王小万[4] 王馨[2] 李建[4] 

机构地区：[1]中南大学公共卫生学院社会医学与卫生事业管理研究室,长沙410078 [2]中国医学科学院阜外心血管病医院国家心血管病中心社区防治部,北京102308 [3]中南大学湘雅三医院医学信息研究湖南省普通高等学校重点实验室(中南大学),长沙410013 [4]中国医学科学院卫生政策与管理研究中心,北京100020

出　　处：《重庆医科大学学报》2016年第4期350-354,共5页Journal of Chongqing Medical University

基　　金：国家卫生行业科研专项资助项目(编号:200902001)

摘　　要：目的：探讨社区高血压患者血压控制效果的影响因素。方法：基于经济发展水平和地理位置,选择16个省250个社区卫生服务中心（站）和卫生院,利用基层高血压规范化管理方案对社区医务人员进行培训,由受培训的基层医务人员对高血压患者实施规范化管理1年。高血压患者的基线和随访资料采用统一设计的调查问卷收集。构造logistic回归模型对高血压控制效果的影响因素进行分析。结果：调查人群高血压治疗控制率为75.2%,年龄大、女性、高中以上、中东部地区和社会医疗保险是高血压控制的有利因素,而新型农村合作医疗、有并发症、2~3级高血压、高危和单片复方制剂是高血压控制的不利因素。结论：在高血压社区规范化管理中,应加强对年轻、有并发症、2~3级高血压以及高危患者的教育与管理,做到早发现、早治疗;同时,卫生行政部门应针对慢性病完善新型农村合作医疗制度,提高患者抗疾病经济风险能力。Objective：To explore the influencing factors of hypertension control for hypertensive patient in community. Methods：Totally250 community health centers（stations）and township hospitals were selected across 16 provinces of China according to geographical locations and economic levels. The primary care physicians were trained in accordance with the guidelines for prevention and control for hypertension in China（the 2009 Community-based revision）,and they were required to implement standardized blood pressure management for hypertensive patients for one year. For each hypertensive patient,information at both baseline and follow-up was collected using a uniform case report form. Logistic regression model was used to analyze the influencing factors of hypertension control. Results：The overall control rate for hypertension was 75.2%. The old age,female,high school degree or above,central and eastern regions and social medical insurance were the favorable factors for hypertension control. However,the new rural cooperative medical system,complications,hypertension at 2-3 levels,high risk and single pill combination were the risk factors for hypertension control. Conclusion：In the hypertension community standardization management,education and management should be strengthen for the young patients with complications or those with hypertension at 2-3 levels. Early detection and early treatment should be advocated. Meanwhile,the administrative department of health should improve the new rural cooperative medical system for chronic diseases in order to enhance the patients＇ ability of resisting disease economic risk.

关 键 词：高血压 社区 效果 影响因素 

分 类 号：R19[医药卫生—卫生事业管理]