三级医院下沉社区医院对社区高血压和糖尿病患者管理效果的影响  

Influence of tertiary hospitals sinking community hospital on the management effect of community hypertension and diabetes

作　　者：杜晓秋[1] 陈刚[1] 宋嫒姝 刘辉[1] 王幻苏 杜励[1] 蒋琴 刘涛[3] DU Xiao-qiu;CHEN Gang;SONG Ai-shu;LIU Hui;WANG Huan-su;DU Li;JIANG Qin;LIU Tao(General Practice,Nanchong Central Hospital,the Second Clinical Medical College of North Sichuan Medical College;The Xinjian Community Hospitalin in Shunqing District of Nanchong;Deparment of Vasculocardiology,Nanchong Central Hospital,the Second Clinical Medical College of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院第二临床学院·南充市中心医院全科医学科 [2]南充市顺庆区新建社区卫生服务中心 [3]川北医学院第二临床学院·南充市中心医院心血管内科,四川南充637000

出　　处：《川北医学院学报》2021年第4期541-544,共4页Journal of North Sichuan Medical College

基　　金：四川省基层卫生事业发展研究中心科研项目(ky-SWFZ17-Y-20)。

摘　　要：目的:研究三级医院下沉基层形成医疗联合体(医联体)对社区医院高血压和2型糖尿病患者管理效果的影响。方法:以435例患者为研究对象,将医联体建设前患者的资料作为对照组,建设后的资料作为研究组。回顾性分析患者的就医满意度、高血压和2型糖尿病等慢性疾病的治疗率及控制率、医疗费用等指标的变化。结果:与医联体建设前相比,三级医院下沉后,社区医院患者的就医满意度(69.43%vs.90.11%,P<0.01)、高血压的治疗率(74.06%vs.96.23%P<0.001)及控制率(59.91%vs.88.21%,P<0.001)、2型糖尿病的治疗率(42.50%vs.70.83%,P<0.001)及控制率(66.67%vs.85.00%,P=0.001)、高血压+2型糖尿病的治疗率(85.44%vs.99.03%,P<0.001)及控制率(53.40%vs.67.48%,P=0.023)均提高,次均住院费用均有不同程度提高(2199.78±99.28 vs.2556.45±88.37,P<0.01),药占比下降(41.22±1.72 vs.38.36±1.56,P<0.05)。结论:三级医院紧密联系基层社区医院,建设成医联体,对国家基本公共卫生服务项目中高血压和2型糖尿病患者的管理效果有明显提升。Objective:To study the effect of community hospitals on hypertension and diabetes management after the construction of health alliance formed by subsiding of tertiary hospitals.Methods:435 patients were selected as the research objects,the data of patients before the construction of health alliance were taken as the control group,and the data after the construction were taken as the research group.The changes of patients'satisfaction with medical treatment,treatment and control rate of hypertension and diabetes,medical cost were analyzed retrospectively.Results:In contrast,patients'satisfaction with medical treatment(69.43%vs.90.11%,P<0.01),the treatment rates(hypertension:74.06%vs.96.23%,diabetes:42.50%vs.70.83%,hypertension+diabetes:85.44%vs.99.03%,P<0.001)and control rates(hypertension:59.91%vs.88.21%,P<0.001,diabetes:66.67%vs.85.00%,P=0.001,hypertension+diabetes:53.40%vs.67.48%,P=0.023),and average cost of each hospitalization(2199.78±99.28 vs.2556.45±88.37,P<0.01)in community hospitals had been improved to varying degrees after the subsidence of tertiary hospitals.And the proportion of drugs in total treatment costs had declined(41.22±1.72 vs.38.36±1.56,P<0.05).Conclusion:With the close health alliance of the tertiary hospital to community hospital,the effectiveness of hypertension and diabetes management has significantly improved in the national basic public health service projects.

关 键 词：医联体 高血压 2型糖尿病 慢病管理 回顾性分析 

分 类 号：R587.1[医药卫生—内分泌] R544.1[医药卫生—内科学]