农村高血压和糖尿病患者对健康管理服务的认知与评价研究:以扬州市江都区为例

The rural hypertension and diabetes patients' perception and evaluation on the health management services

目的:分析农村高血压和糖尿病患者对健康管理服务的认知与评价,发现问题并提出对策。方法:采用分层随机抽样方法调查农村高血压和糖尿病患者570人,应用描述性统计和logistic回归分析患者对健康管理服务的认知与评价。结果:绝大部分农村慢性病患者知晓健康管理服务,对疾病控制效果的满意率达82.28%,其中年龄低于60岁患者的满意率偏低(P<0.05),为77.24%,患者认为健康管理服务内容提供不足的方面主要有上门随访、健康体检和并发症防治(选择比例分别为11.90%、10.41%和9.29%);农村健康管理服务的问题主要有随访次数少、医疗设备不全和服务项目开展不足(选择比例分别为16.36%、9.29%和8.92%)。结论:构建乡村两级医疗卫生机构的协作机制,加大农村公共卫生的投入,加强农村卫生人员培训,合理安排上门随访、健康讲座等,提高高血压和糖尿病等慢性病的管理质量与效果。

Objective： To analyze the perception and evaluation of rural patients with hypertension and diabetes on the health management services,thereby identifying the problems and proposing countermeasures. Methods： 570 rural patients with hypertension and diabetes were investigated by the stratified random sampling method. Descriptive statistic method and logistic regression analysis were applied to analyze the rural patients＇ perception and evaluation on the health management services. Results： The majority of rural patients with chronic diseases such as hypertension and diabetes were alerted of the health management service. The satisfaction rate on the disease control effect was82. 28%,and that among patients below the age of 60 years old was lower than that of the others（ P〈0. 05）.77. 24% of patients deemed that some services such as on-site visit,physical examination and prevention of complications were deficient（ the selection rates among patients were 11. 90%,10. 41% and 9. 29% respectively）. The health management services problems mainly included deficiency of on-site visits,incomplete medical equipments and service items（ the selection rates among patients were 16. 36%,9. 29% and 8. 92% respectively）. Conclusions： In order to improve the quality and positive effect of health management for patients with hypertension and diabetes,the collaborative mechanism between township institutions should be developed,the government should increase investment in rural public health,strengthen the rural heath personnel brainstorming,and on-site visits and debates on health should be reasonably arranged according to the needs of rural patients,and the quality and effectiveness of the management of hypertension and diabetes together with other chronic diseases should be improved.