中国8省（自治区）高血压和2型糖尿病患者健康管理服务实施现状

Evaluation on programs regarding the community-based ma.nagement of hypertension and type 2 diabetes mellitus patients in eight provinces, China

目的了解基本公共卫生服务高血压和2型糖尿病患者健康管理项目的开展现状。方法在全国选取8省（自治区），采用分层多阶段随机抽样方法，共调查≥35岁管理满1年的高血压患者5116名和2型糖尿病患者3586名。通过面对面问卷调查和现场体检，调查患者接受健康管理情况、血压和血糖水平、随访满意度等。结果高血压和糖尿病患者管理率分别为23．6％（城市：17．1％，农村：28．1％，X2=27195．33，P〈O．001）和19．1％（城市：14．1％，农村：23．8％，X2=7423．67，P〈0．001），规范管理率分别为61．1％（城市：63．3％，农村：58．6％，Z2=11．82，P〈0．001）和59．0％（城市：61．5％，农村：55．6％，岔=12．66，P〈0．001），患者血压和血糖控制率分别为50．3％（城市：62．0％，农村：36．6％，x2=329-31，P〈0．001）和53．9％（城市：60．8％，农村：44．7％，）c。=90．53，P〈0．001），高血压和糖尿病患者随访满意率分别为83．0％（城市：84．7％，农村：80．7％，x2=13．42，P〈0．001）和84．5％（城市：88．0％，农村：79．5％，Z2=43．90，P〈0．001）。结论基本公共卫生服务高血压和糖尿病患者健康管理项目取得一定成效。

Objective- To underst,and-the si-tuation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers. Methods In eight provinces being selected, a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year. Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information, blood pressure and situation of glucose control. Results The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6% （urban： 17.1%, rural： 28.1%,X2=27 195.33,P〈0.001） and 19.1% （urban： 14.1%,rural：23.8%,Z2=7 423.67,P〈0.001） while the standardized management rates were 61.1% （urban： 63.3%, rural： 58.6%, ）X2= 11.82, P〈0.001 ） and 59.0% （urban： 61.5%, rural： 55.6%, X2 = 12.66, P〈0.001 ）, respectively. Rate on blood pressure control among hypertension patients and the rate on fasting glucose control on type 2 diabetes mellitus patients were 50.3% （urban： 62.0%, rural： 36.6%, X2=329.31, P〈0.001 ） and 53.9% （urban： 60.8%, rural： 44.7%, X2=90.53, P〈0.001）, respectively. Satisfaction rates for the management service of the hypertension patients and type 2 diabetes mellitus patients were 83.0% （urban： 84.7%, rural： 80.7% , X2=13.42, P〈0.001） and 84.5% （urban： 88.0% , rural： 79.5% , X2=43.90, P〈0.001） , respectively. Conclusion Efficiency was achieved to some extent in managing hypertension and type 2 diabetes mellitus patients in primary health service centers. Further improvement was expected on rates regarding management, standardized management and control on both blood pressure and glucose.