基于“全科医生进校园”模式的学生健康管理效果分析

The analysis on the effect of the general practitioner-led on campus health management

目的研究在中小学校园内实施以全科医生为责任主体,基于信息化的健康管理模式对上海小学生的影响效果。方法调查对象为上海龙柏地区2015学年小学、初中和高中的7875名学生,对其建立学生电子健康档案,对疾病卡建档和随访管理情况进行统计分析。结果2015学年龙柏地区中小学生电子健康档案建档率100%,疾病规范管理率98.96%。经比较分析,不同病种的累计干预效果、最近一次干预效果的差异均有统计学意义(分别χ^2=645.551,P<0.001;χ^2=398.089,P<0.001);经成组独立样本的秩和检验,在5个病种中,针对同一病种的两次干预方式产生的疾病管理效果比较差异均无统计学意义。父母文化程度、学校健康宣传、家庭重视程度对学生疾病健康管理效果的影响有统计学意义[分别OR=0.112(0.086~0.367),P<0.001;OR=6.231(3.086~10.300),P<0.001;OR=2.564(1.665~10.675),P<0.001]。结论“全科医生进校园”的学生健康管理模式,可以规范学生疾病管理,提高疾病健康管理效果,有利于树立学生“知-信-行”健康管理新理念,促进全科医学学科和社区服务事业的发展。

Objective A comprehensive analysis on the effect of the general practitioner-led ( GP-led) campus health management. Methods We established electronic health record ( HER) for 7 875 students from Longbai District,who come from primary and secondary schools in 2015,and performed statistical analysis on Health Card and accompanying visitors. Results Student EHR coverage: 100%; standard disease control: 98. 96%. Statistic significance ( χ^2 = 645. 551,P < 0. 001; χ^2 = 398. 089,P < 0. 001,respectively) has been reached through comparing the effects of accumulative interventions from different diseases,as well as the latest intervention. Meanwhile,independent sample t test and rank sum test has concluded that neither of these interventions has made statistical significance on disease control when exerting to the same disease. In addition,logistic regression analysis has suggested that educated services,campus health advisory,family attention affect disease control with a statistical significance [OR = 0. 112 ( 0. 086,0. 367) ,P < 0. 001; OR = 6. 231 ( 3. 086,10. 300) ,P < 0. 001; OR = 2. 564 ( 1. 665,10. 675) ,P < 0. 001,respectively]. Conclusion The approach of GP-led campus health management had regulated the disease control rate so that it improved the health administration among students. It has also spread the modern concept of knowledge-attitude-belief into health management among teenagers,which would propel the development of GP practice and general communal services.