目的：观察高血压药费减免在农村高血压管理中的效果。方法：对上海金泽镇4个自然村35岁以上人群进行血压普查，1907名高血压患者为研究对象。随机抽取1个自然村为对照组，其余3村为实验组。两组均开展高血压知识健康讲座、建立健康档案，定期随访血压、行心血管风险评估、指导健康的生活方式和合理用药等；实验组的降压药物费用，在新型农村合作医疗报销比例的基础上再减免20%，对照组不减免。比较1年后两组高血压患者的血压变化情况。结果：1年后，实验组的收缩压、舒张压均低于对照组，差异有统计学意义（P<0.05）。实验组患者的控盐率、运动锻炼率、规范服药率、定期测量血压率均高于对照组，差异有统计学意义（P<0.05）。结论：对农村高血压患者开展高血压药费减免是提高高血压管理效果的有效途径之一。%Objective:To observe the effect of hypertension drug fee free in the management of hypertension in the rural areas. Methods:The blood pressure of the population above 35 years old in four villages of Jinze Town of Shanghai were screened and 1 907 patients diagnosed as hypertension were conifrmed as the subjects, and 1 village was randomly selected as the control group and the remaining 3 ones as the experiment group. Both groups were given the hypertension knowledge lectures, establishment of the health ifles, regular following-up blood pressure, cardiovascular risk assessment, guidance of the healthy life way and the rational use of drugs, and the costs of the antihypertensive drugs in the experiment group were reduced 20%based on the new rural health insurance reimbursement ratio but not in the control group. The changes of blood pressure in two groups were compared one year later. Results:One year later the systolic and diastolic blood pressures in the experimental group were lower than those in the control group, and the difference had the statistical signiifcance (P<0.05). The salt controlling rate, exercise rate, standardized medication rate, and regular blood pressure measurement in the experiment group were higher than those in the control group, and the difference had the statistical signiifcance (P<0.05). Conclusion:Implementation of the hypertension drug fee free for the patients with hypertension in the rural areas is one of the effective ways to improve the hypertension management.
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