社区干预对贵阳市高血压患者血压控制效果的影响

摘要

目的：了解贵阳市高血压患者社区卫生服务利用情况及控制效果，评价贵阳市基层卫生服务体系建设和公共卫生政策实施效果。方法：通过分层随机抽样方法，对贵阳市6个社区卫生服务中心的969名高血压患者进行结构式问卷调查。结果：不同类型高血压患者的防治方式和血压控制率之间差异具有统计学意义（ P＜0．05）。兼职和无职业的高血压患者血压未控制的风险分别是全职高血压患者的2．32倍和2．29倍；单纯药物防治和单纯非药物防治，其高血压未控制的风险分别是综合防治的3．70倍和2．41倍；社区基本医疗服务利用频率小于1次/月和不利用的高血压患者，其血压未控制的风险分别是利用频率大于1次/月的1．57倍和2．24倍。结论：无职业或兼职的人群、未采取综合防治手段、社区服务利用不充分是血压控制不良的主要影响因素。%Objective: To explore hypertension in community health care utilization and control outcome in Guiyang City , to reflect develop-ment and effectiveness of basic health care providing system and public health care policy.Methods: 969 hypertension patients were surveyed with structured questionnaire through stratified random sampling in 6 community health care centers in Guiyang City.Results:Blood pressure con-trol rate were statistically significant in different types groups of hypertension (P<0.05).The hypertension patients with part-time job and no-job were 2.32 and 2.29 times more likely to be uncontrolled than hypertension with full-time job.The hypertension patients with less than 1 time per month and zero health care utilization in community were 1.57 times and 2.24 times more likely to be poor hypertension control with more than 1 time per month health care utilization.Conclusion:Compared with hypertension stage one and stage two, patients with hypertension stage three and isolated systolic hypertension were elder, more female and high complication rate, and they were more likely poor hypertension control.Pa-tients with part-time job and no job, less health care utilization were associated with poor hypertension control.