2014年四川省社区高血压和糖尿病患者健康管理服务现状调查

A cross-sectional study on health management service for hypertension and diabetes, Sichuan province, 2014

目的：探讨四川省基本公共卫生服务项目中高血压和糖尿病患者健康管理服务的数量、质量及其效果。方法2014年3月，采取多阶段分层随机抽样方法，在四川省21个市（州）中抽取11个市的22个县（区）的44个乡镇卫生院（社区卫生服务中心），获取高血压和糖尿病患者健康管理率,并在每个乡镇卫生院（社区卫生服务中心）等距抽取高血压和糖尿病档案各10份，开展电话调查，核查档案表单、个人信息、体检记录、随访信息等，根据国家基本公共卫生服务规范设定条件，判断档案信息准确性和服务规范性。比较档案信息准确和不准确、服务规范和不规范的受访对象满意率和控制率。结果高血压和糖尿病患者健康管理率分别为33.8%（69680/206154）和24.0%（25562/106508）。慢性病患者档案信息准确率为81.16%（702/865），服务规范率为74.36%（522/702）,血压控制率为86.92%（299/344），血糖控制率为85.46%（288/337），患者满意率为94.58%（698/738）。档案信息准确和不准确的对象满意率分别为98.69%（677/686）和40.38%（21/52）（χ2=320.52，P〈0.001）；服务规范和不规范的对象满意率分别为99.22%（508/512）和97.13%（169/174）（χ2=2.92，P=0.087）。结论四川省高血压和糖尿病患者健康管理服务质量较好，需进一步提高管理率、档案信息准确率和服务规范率。

Objective To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province. Methods 44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March,2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn＆#39;t. Results 33.8%（69 680/206 154） of the hyperpietics and 24.0% （25 562/106 508） of the diabetics were managed. 81.16%（702/865） of the records were with accurate information. 74.36%（522/702） of the patients received normative services. Blood pressure was well controlled in 86.92%（299/344） of the hyperpietics, and FPG was well controlled in 85.46%（288/337） of the diabetics. The satisfaction rate was 94.58% （698/738）. The satisfaction rate of patients which had accurate record was 98.69%（677/686）, but of which had not was just 40.38% （21/52） （χ2=320.52,P〈0.001）. The satisfaction rate of patients which got normative services was 99.22% （508/512）, and of which did not get was 97.13% （169/174） （χ2=2.92,P=0.087）. Conclusion The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for＆amp;nbsp;increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.