机构托养与非机构托养残疾人健康状况及卫生服务需求分析

Health status and health care service demands analysis between institutional care support and non institutional care support in disabled persons

目的:探索通过对上海市机构托养与非机构托养(家庭看护)残疾人的健康状况评价,以期卫生服务需求分析。方法:本研究从2013—2014年度期间我中心开展到托养机构上门体检的残疾人体检数据(试验组)中随机抽取415例与同年度的非机构托养残疾人的体检数据(对照组)进行1∶1配对,配对标准为相同年龄、相同性别、相同残疾类别、相同残疾等级,总收集样本量830例,对体检结果中的血压、心电图、B超(肝脏、胆囊、胰脏、脾脏)、血红蛋白、甘油三酯、总胆固醇、血葡萄糖、谷丙转氨酶、肌酐进行统计学分析。结果:机构托养残疾人组(试验组)的血压、心电图、B超、血红蛋白、甘油三酯、血葡萄糖指标优于非机构托养残疾人组(对照组)体检指标(P<0.05),而肌酐、谷丙转氨酶两组体检指标无明显差异(P>0.05)。从本研究830例样本中抽取316例精神类残疾患者,对其谷丙转氨酶指标进行统计学分析,两组体检指标无明显差异(P>0.05)。结论:托养机构残疾人一般健康状况优于非机构托养残疾人一般健康状况,精神类残疾患者因长期服用抗精神类药物,影响其肝肾功能,两组谷丙转氨酶指标无明显差异。

Objective： To analyze the health needs through exploring the health status assessment of the disabled persons in institutional care and non-institutional care （family care） in Shanghai. Method： We randomly selected 415 cases from the physical examination data （experimental group） through door-to-door service for the maintenance organization in the period of 2013-2014, and performed 1∶1 matching with the physical examination data of disabled persons（control group） in non institutional care in the same year. Paired with the corresponding age, gender, disability categories and disability level, and totally collected 830 samples. The examination results of blood pressure, ECG, B ultrasound （liver, gallbladder, pancreas, spleen）, hemoglobin, triglyceride, total cholesterol, blood glucose, valley pyruvic transaminase and creatinine were statistically analyzed. Result： The physical indexes of ECG, B ultrasound, hemoglobin, triglyceride, blood glucose of the institutions maintenance disabled group were all better than the non-maintenance organization group （P＜0.05）, while the physical indicators of creatinine and alanine aminotransferase （ALT） in the two groups had no significant difference （P＞0.05）. In this study, 316 cases of mental disability were extracted from 830 samples, and the alanine aminotransferase index was analyzed, which had no significant difference between the two groups （P＞0.05）. Conclusion： The general healthy condition of the disabled in maintenance organization is better than those in non-maintenance organization. For disequilibrium, mental disability patients, the long-term use of antidepressant drugs reduce liver and kidney malfunction with no significant difference of alanine aminotransferase （AST） level between the two groups.