创新社区卫生服务流程应对老龄化等因素带来的慢病挑战

An innovative approach to meet non-communicable diseases challenge of aging society

为了应对老龄化等因素带来的慢性非传染性疾病(简称慢病)对卫生系统的严重挑战,探讨了具有中国本土化特色、适合中国社区特点、共同参与型的社区慢病自我管理的群组看病模式。经社区随机对照试验设计证实了其在改善自我管理行为、提高自信心、改善健康功能状况和情绪低落、提高生活质量、降低卫生服务利用方面的有效性,为慢性病管理问题提供了一条有效的途径。本文还就这一模式的推广,提出了对我国当前卫生体系改革的建议。

An innovative approach was designed with the integration of patient group visiting and self-management to face the challenges of non-communicable diseases（NCD） due to aging population and other emerging risk factors.The members of the group accepted the traditional cultural conception of taking responsibility individually and also sharing duties with society.The participated communities of the study were randomly selected and present results showed that the approach could improve the self-management behaviours,health condition,emotion wellness and life quality of NCD patients,as well as to enhance their self-efficacy and reduce utilization of medical services.The approach should be helpful for health system reform and public health strategy development.