中国8省(自治区)高血压和2型糖尿病患者健康管理服务实施现状

摘要

目的 了解基本公共卫生服务高血压和2型糖尿病患者健康管理项目的开展现状.方法 在全国选取8省(自治区),采用分层多阶段随机抽样方法,共调查≥35岁管理满1年的高血压患者5 116名和2型糖尿病患者3 586名.通过面对面问卷调查和现场体检,调查患者接受健康管理情况、血压和血糖水平、随访满意度等.结果 高血压和糖尿病患者管理率分别为23.6％(城市:17.1％,农村:28.1％,x2=27 195.33,P＜0.001)和19.1％(城市:14.1％,农村:23.8％,x2=7 423.67,P＜0.001),规范管理率分别为61.1％(城市:63.3％,农村:58.6％,x2=11.82,P＜0.001)和59.0％(城市:61.5％,农村:55.6％,x2=12.66,P＜0.001),患者血压和血糖控制率分别为50.3％(城市:62.0％,农村:36.6％,x2=329.31,P＜0.001)和53.9％(城市:60.8％,农村:44.7％,x2=90.53,P＜0.001),高血压和糖尿病患者随访满意率分别为83.0％(城市:84.7％,农村:80.7％,x2=13.42,P＜ 0.001)和84.5％(城市:88.0％,农村:79.5％,x2=43.90,P＜0.001).结论 基本公共卫生服务高血压和糖尿病患者健康管理项目取得一定成效.%Objective To understand the situation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers.Methods In eight provinces being selected,a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year.Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information,blood pressure and situation of glucose control.Results The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6％ (urban:17.1％,rural:28.1％,x2=27 195.33,P＜0.001) and 19.1％ (urban:14.1％,rural:23.8％,x2=7 423.67,P＜0.001) while the standardized management rates were 61.1％ (urban:63.3％,rural:58.6％,x2=11.82,P＜0.001) and 59.0％ (urban:61.5％,rural:55.6％,x2 =12.66,P＜ 0.001),respectively.Rate on blood pressure control among hypertension patients and the rate on fasting glucose control on type 2 diabetes mellitus patients were 50.3％ (urban:62.0％,rural:36.6％,x2=329.31,P＜0.001) and 53.9％ (urban:60.8％,rural:44.7％,x2=90.53,P＜0.001),respectively.Satisfaction rates for the management service of the hypertension patients and type 2 diabetes mellitus patients were 83.0％ (urban:84.7％,rural:80.7％,x2=13.42,P＜0.001) and 84.5％ (urban:88.0％,rural:79.5％,x2=43.90,P＜0.001),respectively.Conclusion Efficiency was achieved to some extent in managing hypertension and type 2 diabetes mellitus patients in primary health service centers.Further improvement was expected on rates regarding management,standardized management and control on both blood pressure and glucose.