医联体模式下社区综合干预措施对社区居民流感疫苗接种率的影响  

Effects of comprehensive community intervention under medical association model on the influenza vaccine coverage rate of community residents

作　　者：胡小英[1] 张小华 杨双 张亚男 施劲东[4] 揭志军[4] Hu Xiaoying;Zhang Xiaohua;Yang Shuang;Zhang Yanan;Shi Jindong;Jie Zhijun(Jiangchuan Community Health Service Center,Shanghai 200240,China;Department of General Medicine,The 10 th People's Hospital Affiliated to Tongji University,Shanghai 200072,China;Zhuanqiao Community Health Service Center,Shanghai 201108,China;Department of Respiratory and Critical Care Medicine,Shanghai Fifth People's Hospital,Fudan University,Shanghai 200240,China)

机构地区：[1]上海市闵行区江川社区卫生服务中心,上海200240 [2]同济大学附属第十人民医院全科医学科,上海200072 [3]上海市闵行区颛桥社区卫生服务中心,上海201108 [4]复旦大学附属上海市第五人民医院呼吸与危重症医学科,上海200240

出　　处：《国际呼吸杂志》2022年第19期1452-1458,共7页International Journal of Respiration

基　　金：上海市卫生和计划生育委员会科研课题(20184Y0264);闵行区自然科学研究课题(2019MHZ009)。

摘　　要：目的评价医联体模式下以家庭医生为主体的社区综合干预措施对社区居民流感疫苗接种率的影响。方法本研究为社区干预实验研究。采用配额抽样法抽取上海市闵行区社区居民3000人,分为对照组和干预组,每组各1500人。对照组实施常规社区公共卫生管理,干预组在对照组基础上开展社区氛围群体干预和流感高危人群个体干预,随访1年(2019年7月至2020年6月)。分析2组居民全人群及流感高危人群干预前后的流感疫苗接种率的变化情况。结果对照组全人群、流感高危人群流感疫苗接种率管理前后差异均无统计学意义(χ^(2)值分别为0.26、0.00,P值均>0.05),而干预组干预后全人群、流感高危人群流感疫苗接种率均较干预前提高,差异均有统计学意义(χ^(2)值分别为34.80、32.84,P值均<0.001)。干预组干预后流感高危人群(去除年龄<5岁儿童)流感疫苗接种率较干预前提高,差异有统计学意义(χ^(2)=33.65,P<0.001),而对照组流感高危人群(去除年龄<5岁儿童)流感疫苗接种率管理前后差异无统计学意义(χ^(2)=1.16,P>0.05)。以家庭为单位,干预组干预后每户家庭流感疫苗接种人数较对照组增加,差异有统计学意义(Z=4.04,P<0.001)。干预组干预前未接种流感疫苗原因前三位是认为自己很健康没必要接种(40.00%,202/505)、之前没听说过流感疫苗(33.07%,167/505)、不知道何时何地去接种(29.32%,148/505),干预后未接种流感疫苗原因前三位是认为自己很健康没必要接种(42.58%,198/465)、流感是小病,不会造成严重后果(24.52%,114/465)、还有其他的防范措施(11.18%,52/465)。结论家庭医生在社区范围开展针对社区全人群的社区氛围和针对流感高危人群个体的综合干预措施,可明显提高全人群和流感高危人群的流感疫苗接种率。Objective To evaluate the effects of comprehensive community intervention dominated by family doctors on the influenza vaccine coverage rate of community residents under the medical association model.Methods A total of 3000 community residents were recruited by quota sampling method and divided into control group and intervention group with 1500 people,respectively in the present study,an experimental study on community intervention.Routine community public health management was implemented for residents in the control group,and the community atmosphere group intervention on individual intervention on high-risk influenza population implemented for residents in the intervention group on the basis of the control group for one year.The residents were followed up for one year(extending from July 2019 to June 2020).The change in influenza vaccination rate of the whole population and high-risk influenza population from two groups of residents before and after intervention were analyzed.Results The difference in the influenza vacine vaccination rate of the whole population and high-risk population group in the control group wasn't statistically significant before and after administration(x^(2)was equal to 0.26 and 0.00 respectively,P>0.05).The vaccination rate of influenza vaccine in the whole population and high-risk influenza population in the intervention group was higher than that before the intervention.The difference was statistically significant(x^(2)was equal to 34.80 and 32.84,respectively,P<0.001).The difference in the influenza vaccine vaccination rate of high-risk population population(excluding children<5 years old)in the control group was not statistically significantly before and after administration(x^(2)=1.16,P>0.05).While the influenza vaccine vaccination rate of high-risk population population(excluding children<5 years old)in the intervention group was higher than that before intervention.The difference was statistically significant(x^(2)=33.65,P<0.001).The number of people vaccinated with influenza

关 键 词：社区综合干预 流感高危人群 流感疫苗接种率 

分 类 号：R186[医药卫生—流行病学]