紧密型医联体模式下分级诊疗对原发性高血压患者管理效果研究

Study on the management effect of graded diagnosis and treatment on patients with essential hypertension under the compact medical consortium model

目的:探讨紧密型医联体模式下分级诊疗对原发性高血压患者的管理效果。方法:选取2020年1月至2020年12月治疗和跟踪管理的85例高血压患者作为观察组,同时选取既往管理的85例高血压患者作为对照组,观察组给予紧密型医联体模式下分级诊疗及管理,对照组给予常规管理,比较两组患者管理前后血压值变化、自我管理效果、管理率、规范管理率、血压控制率。结果:管理前两组患者收缩压、舒张压水平差异无统计学意义(P>0.05),管理后观察组患者收缩压、舒张压改善优于对照组患者(P<0.05);管理前两组患者自我管理能力(饮食管理、用药管理、病情监测、运动管理、工作与休息、情绪管理)评分差异无统计学意义(P>0.05),管理后观察组患者自我管理能力提高程度优于对照组患者(P<0.05);观察组患者管理率、规范管理率、血压控制率较对照组患者均提高(P<0.05)。结论:紧密型医联体模式下分级诊疗可提高原发性高血压患者自我管理能力,控制血压,提高患者基层医疗服务的可及性,但对于紧密型医联体的建设和分级诊疗制度需进一步完善。

Objective:To explore and analyze the management effect of graded diagnosis and treatment on patients with primary hypertension under the compact medical consortium model.Methods:85 hypertensive patients treated and tracked from January 2020 to December 2020 were enrolled as the experimental group.At the same time,85 previously managed hypertensive patients were selected as the control group.The experimental group was given graded diagnosis,treatment and management under the compact medical consortium model,and the control group was given routine management.The changes of blood pressure,self-management effect,management rate,standard management rate and blood pressure control rate were compared between the two groups before and after management.Results:There were no significant differences in systolic and diastolic blood pressure levels between the two groups before management(P>0.05).After management,the improvement of systolic and diastolic blood pressure in the observation group was better than that in the control group(P<0.05).There was no statistical significance in the scores of self-management ability(diet management,medication management,disease monitoring,exercise management,work and rest,and emotional management)between the two groups before management(P>0.05),and the improvement degree of self-management ability in the observation group was better than that in the control group after management(P<0.05).The management rate,standard management rate and blood pressure control rate of observation group were all increased compared with control group(P<0.05).Conclusion:Hierarchical diagnosis and treatment under the compact medical consortium model can improve the self-management ability of patients with essential hypertension,control their blood pressure,and improve the accessibility of patients'primary medical services.However,the construction of the compact medical consortium and the hierarchical diagnosis and treatment system need to be further improved.