重点人群动态管理系统对老年慢病患者慢病防治素养水平的影响  

Analysis of the Impact of Key Population Dynamic Management System on the Level of Chronic Disease Prevention and Control Knowledge Literacy of Elderly Patients with Chronic Diseases

作　　者：王亚珍 栾晶[2] Wang Yazhen;Luan Jing(Qibao Community Health Care Center,Shanghai 210000,China;Minhang District Center for Disease Control and Prevention,Shanghai 210000,China)

机构地区：[1]上海市闵行区七宝社区卫生服务中心,上海210000 [2]上海市闵行区疾病预防控制中心,上海210000

出　　处：《健康教育与健康促进》2025年第1期71-74,共4页Health Education and Health Promotion

摘　　要：目的了解社区卫生服务中心重点人群动态管理系统使用前后老年慢性病患者的慢性病防治知识素养水平及其影响因素。方法采用分层多阶段随机抽样法选取重点人群动态管理系统中的患者564人,于系统使用前和使用1年后分别对患者进行问卷调查。结果系统使用前,调查对象的慢性病防治知识得分为(7.07±2.18),慢性病防治素养水平为14.29%;系统使用1年后,该人群的慢性病防治知识得分和慢性病素养具备水平分别上升到7.4±2.43和21.25%。多因素logistic回归分析显示,文化程度、家庭人口数、是否关注随访系统信息是老年慢性病患者慢性病防治素养的影响因素(P<0.05)。结论重点人群动态管理系统实现了个性化健康管理,通过后台发送健康相关知识给老年慢病患者,辅助提升患者的慢性病知识素养水平,并且提高了家庭医生团队的工作效率,值得普及。Objective To understand the level of chronic disease prevention and control knowledge and its influencing factors of elderly patients with chronic diseases before and after the use of dynamic management system for key population in Community Health Care Center.Methods A total of 564 patients in the key population dynamic management system were selected by stratified multistage random sampling method,and the patients were surveyed twice before and after the use of the system for one year.Results Before using the system,the score of chronic disease prevention and control knowledge was(7.07±2.18),and the level of chronic disease prevention and control literacy was 14.29%;after one year of using the system,the score of chronic disease prevention and control knowledge and the level of chronic disease literacy increased to(7.4±2.43)and 21.25%,respectively.Multivariate logistic regression analysis showed that education level,family population and whether to pay attention to the followup system information were the influencing factors of chronic disease prevention and control literacy of elderly patients with chronic diseases(P<0.05).Conclusion The key population dynamic management system realizes personalized health management,sends health-related knowledge to elderly patients with chronic diseases through the background,helps to improve the knowledge literacy level of patients with chronic diseases,and improves the work efficiency of the family doctor team,which is worthy of popularization.

关 键 词：重点人群动态管理系统 慢性病患者 社区健康管理 健康素养 

分 类 号：G63[文化科学—教育学]