泸州市社区高血压患者规范化健康管理及影响因素分析

Standardized health management and influencing factors of hyPertension Patients in Luzhou community

目的本研究分析社区高血压患者规范化健康管理情况及影响因素,为基层卫生服务中心调整健康管理服务方法和激发患者参与规范化健康管理干预路径提供参考。方法2019-03-01-2019-09-30采用自行设计的《社区高血压健康管理调查问卷》对大山坪、北城、莲花池和红星社区卫生服务中心参加慢性病管理的高血压患者进行调查,分析其影响因素。结果泸州市1494例参加管理的患者中,规范化健康管理率为47.5%。单因素分析结果显示,年龄(χ2=12.074,P=0.001)、户籍(χ2=16.592,P<0.001)、文化程度(χ2=6.419,P=0.040)、职业(χ2=11.455,P=0.003)、家庭人均月收入(χ2=7.334,P=0.007)、患病年限(χ2=22.944,P<0.001)、合并糖尿病情况(χ2=6.872,P=0.009)和高血压防治知识及格与否(χ2=7.203,P=0.007)与高血压患者规范化管理率有关联。非条件Logistic回归分析结果显示,本地户籍(OR=1.628,95%CI为1.102~2.405,P=0.014)、参加健康管理年限2~4年(OR=2.708,95%CI为1.865~3.933,P<0.001)、参加健康管理年限≥5年(OR=3.475,95%CI为2.417~4.996,P<0.001)、高血压防治知识及格(OR=0.612,95%CI为0.462~0.812,P=0.001)和健康管理效果为优良(OR=2.350,95%CI为1.330~4.153,P=0.003)是规范化健康管理的影响因素。结论泸州市社区高血压患者规范化健康管理率不高,相关部门应加大高血压健康管理相关政策的宣传力度,不断改善社区卫生服务中心的医疗水平和服务质量,使体检、随访和健康教育等慢性病管理工作落到实处,以提高高血压规范化管理率。

Objective This study analyzed the standardized health management status and influencing factors of hyPertensive Patients in the community,and provided a reference for the primary health service center to adjust the service methods of health management and activate the intervention path of patients to participate in standardized health management.Methods From March 1 to September 30,2019,a self-designed"community hypertension health management questionnaire"was used to survey patients with hypertension participating in chronic disease management in DashanPing,Beicheng,Lianhuachi and Hongxing Community Health Service Centers.Results Among the 1494 patients who participated in the management in Luzhou City,the standardized health management rate was 47.5%.The univariate analysis results showed that age(χ2=12.074,P=0.001),household registration(χ2=16.592,P<0.001),education level(χ2=6.419,P=0.040),occupation(χ2=11.455,P=0.003),family monthly income per capita(χ2=7.334,P=0.007),number of years of illness(χ2=22.944,P<0.001),diabetes mellitus(χ2=6.872,P=0.009),and whether knowledge of hypertension prevention and treatment was qualified or not(χ2=7.203,P=0.007)were related to the standardized management rate of hypertension patients.The results of unconditional logistic regression analysis showed that household registration(OR=1.628,95%CI:1.102-2.405,P=0.014),and the filing period was 2-4 years(OR=2.708,95%CI:1.865-3.933,P<0.001),The filing period≥5 years(OR=3.475,95%CI:2.417-4.996,P<0.001),knowledge of hypertension prevention and treatment was qualified(OR=0.612,95%CI:0.462-0.812,P=0.001)and participation in the management effect self-evaluation was excellent(OR=2.350,95%CI:1.330-4.153,P=0.003)were the main influencing factors of standardized health management.Conclusions The rate of standardized health management of hypertension in communities in Luzhou city is not high.Relevant departments should increase the publicity of related policies on hypertension health management,continuously improve the medical level and service quality of community health service centers,and make physical examinations,follow-ups,and health education for chronic diseases implemented to improve the standardized management rate of hypertension.