江苏省基本公共卫生服务慢性病均等化现状分析

Analysis on the status of non-communicable chronic diseases in basic public health service equalization project in Jiangsu Province

目的:了解江苏省基本公共卫生服务项目中高血压、糖尿病项目均等化现状。方法:2015年1月至3月在江苏省内选取22个样本县市区,通过横断面调查,共调查254所乡镇基层医疗卫生机构开展高血压、糖尿病防治内容,比较慢性病均等化情况。结果:乡镇基层医疗卫生机构实际服务人口数是常住人口数的1.13倍,高血压患者登记率、规范管理率、健康体检率和血压控制率分别为59.15%、83.28%、76.31%、74.56%,2型糖尿病患者登记率、规范管理率、健康体检率、血糖控制率分别为30.11%、80.33%、75.13%、73.65%。农村地区两种慢性病的规范管理率、糖尿病患者健康体检率和血糖控制率高于城市。苏北地区两种慢性病的登记率和健康体检率高于苏南。流动人口比例<10%的地区两种慢性病的健康体检率、血糖控制率高于流动人口比例>10%的地区,差异均有统计学意义(P<0.05)。结论:江苏省基层医疗卫生机构开展慢性病防治工作进展顺利,均等化尚可,但仍有继续提升的空间。出台相关政策,增加服务人口经费投入,明确服务标准,可促进基本公共卫生服务均等化工作良性发展。

Objective： The purpose of this study was to understand the situation of hypertension （HTN） and type 2 diabetes （T2DM） as part of the basic public health service equalization in Jiangsu Province. Methods： A cross-sectional survey was conducted in 254 town-level basic health institutions of 22 sample counties between January and March, 2015. Results： The actual population receiving the town-level services was 1.13 times the number of resident population. The registration rate, standardized management rate, health examination rate and blood pressure control rate of HTN patients were 59.15%, 83.28%, 76.31%, and 74.56%. The same rate of T2DM patients were 30.11%, 80.33%, 75.13%, 73.65%. The standardized management rate of HTN and T2DM, the health examination rate of T2DM and blood glucose control rate in rural areas were higher than urban. Northern Jiangsu had higher registration rate and health examination rate of both two diseases than that in SouthernJiangsu. The physical examination rate and blood glucose control rate was higher in where had less Floating population （internal migration）, using 10% as distinguishing standard （P〈0.05）. Conclusion： The prevention and control work of non-communicable chronic diseases in basic public health service project in Jiangsu province is improving and equalization. Introducing relevant policy, increasing the funding for service population, definite understand standards definition can promote and improve the basic public health services at basic health institutions.