广州市白云区景泰街社区卫生服务及社区卫生诊断分析

Analysis of Community Health Services and Community Health Diagnosis in Jingtai Street,Baiyun District of Guangzhou

目的通过社区卫生诊断,确定社区主要健康问题及危险因素;结合社区实际情况及疾病特征进行综合分析,提出优先干预项目,为制定社区卫生服务工作规划提供依据。方法于2009年9月—2010年1月进行社区现有资料收集和居民卫生调查、服务对象满意度调查以及社区卫生服务机构调查。结果社区卫生服务中心护士极度缺乏,医护比为1.32:1;公共卫生医师只有5人。老年人建档管理率为10.72%,高血压、糖尿病及恶性肿瘤患者年人均管理0次;未对脑血管病及冠心病患者进行建档管理。2009年社区传染病中,肝炎(35.97/万)、肺结核(22.55/万)、手足口病(21.43/万)、水痘(19.94/万)、其他感染性腹泻(16.03/万)占传染病总发病人数的65.96%。恶性肿瘤、呼吸系统疾病、心血管疾病死亡人数占总死亡的52.83%。居民前五种慢性病为高血压、糖尿病、冠心病、骨质增生、脑卒中;两周患病前五种疾病为上呼吸道感染、支气管炎、高血压、冠心病、颈椎病。结论 (1)社区卫生服务中心应完善相关社区卫生服务功能,重点落实公共卫生服务,增加社区护士和公共卫生医师配置。(2)社区重点干预的慢性非传染性疾病为高血压、糖尿病、冠心病、脑卒中、恶性肿瘤;传染病管理的重点为肝炎、肺结核、手足口病、水痘、其他感染性腹泻。

Objective By analysis of community health diagnosis to figure out the main health problems and risk factors,and according to the comprehensive analysis of the community realities of the situation and the disease characteristics to bring up some interference items in advance so as to provide evidence for set up the community health service plan. Methods The work of community health diagnosis had been carried out from September 2009 to January 2010.At the same time,the available information of the community had been collected;and the residents＇ health,the customers＇ satisfaction and the community health service institutions had been surveyed. Results The community health service centers had faced an serious shortage of nurses,and the ratio of doctors to nurses was 1.32：1.There were only 5 public health physicians.The rate of the elderly health archive management was 10.72%.The average of yearly management per capita for patients with hypertension,diabetes mellitus,and malignant tumour was zero.The health archives of patients with cerebrovascular diseases and coronary diseases had not been built up.Among the infectious diseases in Jingtai community in 2009,there were hepatitis of 193 cases（3.597/thousand）,tuberculosis of 121（2.255/thousand）,hand-foot-and-mouth disease of 115（2.143/thousand）,varicella of 107（1.994/thousand）,and other infectious diarrhea of 86（1.603/thousand）,accounting for 65.96% of the total incidence of infectious diseases.The mortality rates of malignant tumors,respiratory system diseases,and cardiovascular diseases accounted for 52.83% of total mortality.The top five chronic diseases were hypertension,diabetes mellitus,coronary disease,osteoproliferation and stroke.The first five diseases of the overall disease prevalence in the past two weeks were upper respiratory tract infection,bronchitis,hypertension,coronary disease and cervical spondylosis. Conclusion（1）The community health service centers should improve the relative functions of community health services,focus on the implementation of public health and increase the staffing of community nurses and public health physicians.（2）The non-infectious diseases which need to be considerably intervened are hypertension,diabetes mellitus,coronary disease,stroke and malignant tumor.The key for infectious disease management is to treat hepatitis,tuberculosis,hand-foot-and-mouth disease,varicella and other infectious diarrhea.