乌鲁木齐市3个社区高血压、糖尿病的社区慢性病管理效果评价  

Chronic disease management effect on hypertension and diabetic patients in three communities in Urumqi

作　　者：叶晨航 吴雪莹 王敏[1] 贾小梅 姚萱[1] YE Chenhang;WU Xueying;WANG Min;JIA Xiaomei;YAO Xuan(School of Public Health,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学公共卫生学院

出　　处：《新疆医科大学学报》2019年第7期948-953,958,共7页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2016D01C174)

摘　　要：目的对乌鲁木齐市3个社区高血压、糖尿病患者社区管理工作的效果进行评价,以此为提高社区慢性病管理水平提供理论依据。方法在乌鲁木齐市新市区、天山区、沙依巴克区各抽取一个社区卫生机构为调查区域,对区域内高血压和糖尿病患者进行问卷调查;调查内容包括高血压、糖尿病患者基本情况,社区卫生服务利用情况及影响因素等。发放问卷846份,有效问卷822份,有效率为99.1%。结果高血压患者社区卫生服务总体利用情况好于糖尿病患者(86.2%vs 80.6%),差异有统计学意义(P<0.05)。高血压患者"定期随访"(81.53%vs 60.89%)、"慢性病讲座"(73.34%vs 62.90%)、"免费体检"(65.85%vs 57.26%)项目利用情况好于糖尿病患者,差异有统计学意义(P<0.05),两种慢性病患者"建立居民健康档案"(75.44%vs 69.76%)项目利用情况差异无统计学意义(P>0.05)。"医保类型"和"家庭到社区的距离"是影响两种慢性病患者社区卫生服务利用的共同因素,"城镇职工医保类型"和"家庭到社区的距离在1公里之内"的患者社区卫生服务的利用情况好于其他医保类型和距离可及性的患者;"婚姻状况"是影响糖尿病患者社区卫生服务利用的特有因素,"已婚且配偶健在"的患者利用情况好于其他婚姻状况患者。结论高血压患者社区卫生服务利用情况好于糖尿病患者;以社区慢性病管理为重点,开展有针对性的社区慢性病服务工作,提高慢性病管理服务质量,提升居民对社区卫生服务的认可度;推进社区基本公共卫生与基本医疗服务的供给侧改革,以慢性病管理带动基本公共卫生服务工作的开展,并以此示范引领国家其他慢性病管理工作。Objective The effect of community management of hypertension and diabetes patients in Urumqi from the perspective of the demand side were evaluated, so as to provide a theoretical basis for management of chronic diseases in the community. Methods A community health institution was selected as a survey area in Tianshan District and Shayibak district of Urumqi. Questionnaires were surveyed for hypertension and diabetes patients in the region. The survey included basic conditions of community, the status of hypertension and diabetes, health service utilization and influencing factors. 846 questionnaires were issued and 822 valid questionnaires were recollected, the effective rate was 99.1%. Results The overall utilization of community health services in patients with hypertension was better than that in diabetic patients(86.2% vs 80.6%), and the difference was statistically significant(P<0.05). The utilization of the following items for Hypertension patients:"regular follow-up"(81.53% vs 60.89%),"chronic disease lecture"(73.34% vs 62.90%),"free physical examination"(65.85% vs 57.26%) were better than that of diabetic patients, and the difference was statistically significant(P<0.05). There was no statistical difference between the patients in two types of in chronic diseases(establishing a resident health record)(75.44% vs 69.76%)."Medical insurance type" and "family-to-community distance" were common factors affecting the utilization of community health services in two chronically ill patients, and "patient health insurance types" with "family-to-community distance within 1 km" of patient community health services was better than that of other types of medical insurance and distance access;"marital status" was a unique factor affecting the utilization of community health services in diabetic patients. The use of community health services in the patients of "married and spouse is alive" was better than that of other marital status patients. Conclusion The utilization of community health services in patients with hyp

关 键 词：高血压 糖尿病 社区卫生机构 基本公共卫生服务 利用情况 影响因素 

分 类 号：R197[医药卫生—卫生事业管理]