某功能社区职业人群高血压规范化管理效果评价  

Evaluation standardized management effect among hypertension of occupational groups at a community

作　　者：蒋品[1] 李结华[1] 唐海沁[1] 黄芬芬 郎翠凤 JIANG Pin;LI Jie-hua;TANG Hai-qin;HUANG Fen-fen;LANG Cui-feng(Department of General Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院全科医学科

出　　处：《中国临床医生杂志》2019年第12期1419-1422,共4页Chinese Journal For Clinicians

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2015133)

摘　　要：目的分析比较某功能社区职业人群高血压规范化管理的相关影响因素,总结功能社区职业人群高血压患者规范化管理的经验。方法纳入安徽省合肥市红光社区卫生服务中心医保定点的职业人群高血压进行规范化管理24个月,对规范化管理前后职业人群相关指标的变化以及管理效果进行分析评估。结果通过24个月的规范化管理,职业人群高血压患者的知晓率、治疗率、控制率提高,差异有显著性(P<0.001);高血压患者自我监测血压频率均有所增加,差异有显著性(P<0.001);收缩压和舒张压、肌酐、空腹血糖、甘油三酯较干预前均有显著降低(P<0.001)。影响职业人群高血压规范化管理的因素为收入水平、社区定点就诊、信息化健康教育。结论职业人群高血压规范化管理应充分利用功能社区的特点,建立全科服务团队,结合患者的经济水平、医保报销比例,建立规范化管理体系。Objective To evaluate the effect of the standardized management for Hypertension in Occupations at a functional community,the main ndicators.Through analyzing and comparing,to occur lessons about standardized management of patients with hypertension.Method After 24 months’ standardized management for hypertension of occupations in Hongguang community health service center in Hefei.Compare the effect of changes and analyze the factors of occupation standardized management of hypertension.Result After 24 months’ standardized management,There were significant statistical differences in status of treatment and control and awareness(P<0.05) between the intervention.There were significantly increasing differences of hypertensive patients ’ self-monitoring of blood pressure and frequency(P<0.001).There was statistical significance in systolic and diastolic blood pressure,serum Creatinine,fasting glucose,triglycerides(P<0.001).The multi-variable analysis showed these factors related to the standardized intervention for hypertension,including income level,communities designated for treatment,health education information.Conclusion We should fully use of the characteristics of functions of the community,to establish general services team.In the standardized management process,we should combine with the economic level of the patients,sand medicare reimbursement to develop individualized treatment programs.

关 键 词：职业人群 规范化管理 社区 影响因素 

分 类 号：R544[医药卫生—心血管疾病]