健康管理新模式对北京天桥社区居家老人慢性病管理的效果分析

Effect of New Health Management Model on Chronic Disease Management of the Elderly at Home in Beijing Tianqiao Community

目的:探讨健康管理新模式对北京天桥社区居家老人慢性病管理的效果。方法:选取天桥社区卫生服务中心在册管理慢性病患者200例,随机分为观察组和对照组,各100例。观察组应用互联网+血压血糖监测管理系统,对照组进行常规慢性病管理,跟踪随访1年。观察两组管理前后高血压/糖尿病知识知晓率变化,比较管理后两组高血压/糖尿病控制率变化。结果:管理后对照组高血压、糖尿病知晓率与管理前类似,而管理后观察组高血压、糖尿病知晓率高于管理前,差异有统计学意义(P<0.05);观察组两种慢性病的控制率81.10%高于对照组49.32%,差异有统计学意义(P<0.05)。结论:健康管理新模式能够对慢性病进行实时监控、管理以及干预,转变传统健康理念,提升社区医疗服务水平,减轻政府医疗负担,更便于国家打造慢病防控体系。

Objective:To explore the effects of new health management model on the management of chronic diseases for the elderly at home in Tianqiao community in Beijing.Methods:A total of 200 patients with chronic diseases registered in the management of Tianqiao Community Health Service Center were selected and randomly divided into observation group and control group,with 100 cases in each group.The observation group used the Internet+blood pressure and blood glucose monitoring management system,and the control group used routine chronic disease management,all patients were followed up for one year.The changes in the awareness rate of hypertension/diabetes knowledge between the two groups before and after management were observed,and the changes in the control rate of hypertension/diabetes between the two groups after management were compared.Results:The awareness rate of hypertension and diabetes in the control group after management was similar to that before management,while the awareness rate of hypertension and diabetes in the observation group after management was higher than that before management,with statistically significant difference(P<0.05);the control rate of the two chronic diseases in the observation group 81.10%was higher than that in the control group 49.32%,with statistically significant difference(P<0.05).Conclusion:The new health management model can carry out real-time monitoring,management and intervention of chronic diseases,transform traditional health concepts,improve community medical service levels,reduce government medical burden,and facilitate the country to build a chronic disease prevention and control system.