迁安市农村社区高血压药物干预效果评价  

Effectiveness evaluation of an anti-hypertensive medical intervention in a rural community in Qian-an

作　　者：王红 李全生 丁鹏 张晓慧[4] 冯福民 王瑞福[4] 

机构地区：[1]华北理工大学公共卫生学院,河北唐山063000 [2]迁安市夏官营中心卫生院,河北迁安064409 [3]宁夏卫生和计划生育监督局,宁夏回族自治区银川750004 [4]唐山市疾病预防控制中心,河北唐山063000

出　　处：《现代预防医学》2016年第21期3910-3914,共5页Modern Preventive Medicine

摘　　要：目的 评价迁安市某乡镇卫生院在农村社区高血压患者中推行的免费药物干预项目的效果。方法 从卫生院免费药物管理系统中调取2008年7月至2015年7月的全部高血压患者数据,并结合2011年至2015年新农合报销系统中的心脑血管疾病相关数据,以血压控制率和住院率为主要指标,对免费药物干预项目的效果进行评价。结果 本研究显示,干预后患者累计血压控制率为55.38%,干预时间、首诊收缩压（SBP）与首诊舒张压（DBP）是影响高血压控制率的影响因素。干预时间的OR值为1.012（1.004-1.019）;首诊SBP的OR值为0.964（0.958-0.970）;首诊DBP的OR值为0.986（0.976-0.997）。干预后患者SBP累计下降了（25.05±20.47）mm Hg,DBP累计下降了（13.58±12.15）mm Hg。近5年推行免费药物干预乡镇的高血压相关心脑血管疾病的住院率低于其余乡镇,且在2015年出现明显下降,提示该免费药物干预可以有效降低高血压相关心脑血管疾病的发病。结论 该农村社区推行的免费药物干预项目对高血压的控制有较好的效果,坚持推行可以预防和减少心脑血管疾病的发生。Objective To evaluate the effectiveness of a free anti - hypertensive medical intervention in a community - based outreach clinic in rural Qianan, Hebei Province. Methods The data of hypertension patients was collected through the free drugs management system in the health center from July 2008 to July 2015. As the main outcomes, the rate of blood pressure control and hospitalization rate were obtained through the reimbursement system of the New Rural Cooperative Medical System from 2011 to 2015 and used to estimate the effectiveness of the free anti - hypertensive medical intervention program. Results Our results showed that the blood pressure control rate reached 55.38% after the intervention. The influence factors of the blood pressure control rate were the intervention time （OR = 1. 012,95% CI： 1. 004 -1. 019） ,the level of SBP before the intervention （ OR = 0. 964,95% CI：0. 958 - 0. 970 ） and D BP before the intervention （ OR = 0. 986,95 % CI：0. 976 - 0. 997 ）. In addition, the average decrease for systolic and diastolic BPs arc （25.05 20.47 ） mm Hg and （ 13.58 12. 15 ） mm Hg respectively. Comparing with neighboring communities that did not participate in the free anti -hypertensive medical intervention programs, the hospitalization rate of cardio - cerebrovascular disease related to hypertension for the intervention community in the recent 5 years was lower, especially in 2005. This suggested that the free drug intervention could decrease the risk of cardio - cerebrovascular disease related to hypertension. Conclusion The free anti - hypertensive medicine intervention program in this rural community is effective in controlling high blood pressure. Stick to the program can help to prevent and reduce the incidence of cardio - cerebrovascular disease.

关 键 词：农村 高血压 干预 效果评价 

分 类 号：R181.35[医药卫生—流行病学]