健共体模式下高血压免费药物配送项目阶段性效果评估  

Phased effect evaluation of the free antihypertensive drugs delivery project under the health alliance model

作　　者：施利杰[1] 董晓莲[1] 徐海涛[1] 崔月颖 李玉荣 吴亚芳 赵玉兰 SHI Lijie;DONG Xiaolian;XU Haitao;CUI Yueying;LI Yurong;WU Yafang;ZHAO Yulan(Chronic Disease Department,Deqing County Center for Disease Prevention and Control,Deqing 313200,China;School of Public Health,Hangzhou Normal University,Hangzhou 311121,China;School of Public Health,Fudan University,Shanghai 200433,China)

机构地区：[1]德清县疾病预防控制中心慢性非传染性疾病防制所,浙江德清313200 [2]杭州师范大学公共卫生学院,浙江杭州311121 [3]复旦大学公共卫生学院,上海200433

出　　处：《健康研究》2022年第1期9-13,共5页Health Research

基　　金：国家卫生健康委员会卫生技术评估重点实验室2019年度开放基金项目(FHTA2019-04)。

摘　　要：目的评估德清县健共体模式下高血压免费药物配送项目对高血压及相关疾病的阶段性防控效果。方法收集德清县综合管理平台2018—2019年免费药物配送记录、电子健康档案2017—2019年慢病随访记录、医保局2014—2019年心脑血管疾病就诊报销记录以及相关医疗费用,进行统计分析。结果2019年登记管理的高血压患者中有13.06%享受免费用药,相比2018年上升了15.32%;2019年高血压患者规范管理率、血压控制率分别较2017年上升1.26%和22.18%,但免费药物多为短效药,对血压控制效果不如长效药物。近3年心脑血管疾病发病率下降趋势(下降16.5%)优于浙江省各县市平均水平(市平均下降7.8%,省平均上升0.9%),虽2014—2019年全县心脑血管疾病医疗费用逐年增高,但2019年增长幅度下降明显。结论免费用药项目政策实施以来,德清县高血压患者免费用药比例和总体血压控制率有提升,对预防和延缓心脑血管疾病发病具有积极意义,但免费药物多为短效药,需要进一步优化药物种类。Objective To evaluate phased effect of the free antihypertensive drugs delivery project on hypertension and related diseases under the health alliance model in Deqing County.Methods Relevant data of Deqing County were collected for statistical analysis,including free drug delivery records of the integrated management platform from 2018 to 2019,follow-up information of chronic diseases of the Electronic Health Records from 2017 to 2019,and medical insurance bureau’s medical reimbursement records of cardio-cerebrovascular diseases and related medical expenses from 2014 to 2019.Results There were 13.06%of patients with hypertension registered for management enjoyed free drugs in 2019,with an increase of 15.32%compared with 2018.In 2019,the standardized management rate and blood pressure control rate of hypertensive patients were increased by 1.26%and 22.18%compared with 2017 respectively.However,the majority of free drugs were of short-term effectiveness,which were inferior to long-acting drugs in controlling hypertension.In the past three years,the descending trend of the incidence of cardio-cerebrovascular diseases(a decrease of 16.5%)was more significant than the average level of counties and cities of Zhejiang province(an average decrease of 7.8%of cities and an average increase of 0.9%of the province).Although the medical expenses on cardio-cerebrovascular diseases of the county rose year by year from 2014 to 2019,its growth presented an obvious decline in 2019.Conclusions In Deqing County,since the free drugs delivery policy being implemented,both free medication rate and overall blood pressure control rate in patients with hypertension had been improved,which was of positive significance for preventing and delaying the incidence of cardio-cerebrovascular diseases.However,most free drugs were short-acting drugs,and the types of drugs needed to be further optimized.

关 键 词：医共体 健共体 高血压 免费药物 评估 

分 类 号：R181.35[医药卫生—流行病学]