健康管理对老年人慢性疾病的干预效果评价  

Effect of health management interventions on chronic diseases in the elderly

作　　者：吴晓丽 徐辉 余清 吴振春[3] 王否 巢健茜[1] WU Xiao-li;XU Hui;YU Qing;WU Zhen-chun;WANG Fou;CHAO Jian-qian(Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China;Department of Cardiology, Qinhuai Hospital, Nanjing 210006, China;Department of Medical Insurance, School of Public health, Southeast University, Nanjing 210009, China)

机构地区：[1]东南大学公共卫生学院流行病与卫生统计学系,江苏南京210009 [2]南京市秦淮医院心血管内科,江苏南京210006 [3]东南大学公共卫生学院医疗保险教研室,江苏南京210009

出　　处：《中华疾病控制杂志》2018年第6期573-576,639,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81273189)

摘　　要：目的评价健康管理干预手段对老年人慢性疾病的效果,为老年人慢性疾病防治提供建议。方法招募2013年3~12月到南京市某社区医院进行体检的60岁及以上老年人作为调查对象,筛选患有高血压、糖尿病患者654名,随机分成管理组和对照组,管理组进行为期18个月的健康管理,对照组常规管理,比较管理前后的客观指标和生命质量改变情况。结果健康管理干预后,管理组与对照组相比,收缩压控制平均降低(5.56±1.66)mmHg、舒张压控制平均降低(2.94±1.24)mmHg、血糖控制平均降低(0.70±0.12)mmol/L,差异均具有统计学意义(均有P<0.05)。生命质量方面,管理组与对照组相比,躯体功能得分平均提高(0.81±0.06)分、心理功能得分平均提高(0.75±0.07)分、社会功能方得分平均提高(0.81±0.09)分、糖尿病特异模块得分平均提高(2.07±0.10)分、生命质量得分平均提高(0.95±0.04)分、而高血压特异模块得分平均降低(0.67±1.12)分,差异均具有统计学意义(均有P<0.05)。由多水平模型可知,在管理期内,管理组生命质量得分每月增加0.03分,对照组生命质量得分每月减少0.04分。老年人慢性疾病患者的生命质量随时间迁移有所提升。结论健康管理的实施有利于慢性疾病患者对血压及血糖的控制,且对老年人慢性病患者生命质量的提高具有一定的积极作用。Objective To evaluate the effect of health management interventions on chronic diseases in the elderly and provide policy recommendations for the prevention and treatment of chronic diseases in the elderly. Methods The eld- erly over 60 years old who received the physical examination in a community hospital in Nanjiug were recruited. A total of 654 patients with hypertension or diabetes were selected. The patients were randomly divided into control group and man- agement group. Health management interventions were conducted for 18 months in the management group, while the control group was under regular management without any interventions. Health status and the quality of life before and after the in- terventions were compared. Results The 18-month health management interventions were beneficial to the control of blood pressure and blood glucose in patients with chronic disease. Compared with the control group, the mauagement group had an average decrease of （5.56 ±1.66） mmHg in systolic pressure control, （2. 94 ±1.24） mmHg in diastolic pressure and （0. 70 ±0. 12） mmol/L in blood glucose, which were all statistically significant （all P 〈 0. 05 ）. As for the quality of life, compared with the control group, the management group had an average increase of （0. 81± 0.06） points in the physical function scores, by （0.75 ±0. 07 ） points in the psychological function scores, by （0. 81 ± 0. 09） points in the social func- tion scores, by （2. 07 ±0. 10） points in the diabetes-specific module and by （0. 95±0. 04） points in the quality of life scores. However, the score of the hypertension-specific module decreased by （0. 67 ± 1.12） points. The differences were all statistically significant （ all P 〈 0. 05 ）. The multilevel model showed that the quality of life of the management group in- creased by 0. 03 points per month, and the quality of life of the control group decreased by 0. 04 points per month in the management period. The quality of life of the elderly patie

关 键 词：健康管理 干预 慢性疾病 效果 

分 类 号：R181.37[医药卫生—流行病学] R544.1[医药卫生—公共卫生与预防医学]