高血压患者的国家基本公共卫生服务自评受益率与服务满意度调查

Hypertension Patients' Self-rated Improvement Gained from and Satisfaction with the National Essential Public Health Services

背景国家基本公共卫生服务项目自2009年至今已开展13年,是我国迄今为止针对高血压患者开展的最大范围的人群干预实践,了解该人群对干预实践的反馈,对于推动国家基本公共卫生服务的持续发展非常重要。目的探讨高血压患者的国家基本公共卫生服务自评受益率与满意度,为促进国家基本公共卫生服务实现高质量发展提供科学依据。方法采用多阶段分层抽样方式,于2019年11—12月在我国东、中、西部地区5市10区(县)20个社区卫生服务中心或乡镇卫生院抽取2419例≥35岁的高血压患者进行问卷调查。问卷由两部分组成:一般人口学信息和高血压患者健康管理情况。结果86.26%(2072/2402)的调查对象认为其所接受的基本公共卫生服务对其健康改善具有帮助。分别有97.15%(2349/2418)、94.09%(2275/2418)、88.16%(2129/2415)、87.81%(2118/2412)、61.36%(1469/2394)、95.04%(2297/2417)、83.67%(2013/2406)、82.34%(1981/2406)、95.53%(2310/2418)的高血压患者对医护人员服务态度、医护人员服务水平、体格检查、健康教育、中医药治疗、随访服务、高血压并发症筛查、血压控制效果及总体服务表示满意。不同文化程度、不同自评健康状况、是否在基层首次发现血压异常、过去1年内接受不同随访服务次数的高血压患者的自评获益率比较,差异有统计学意义(P<0.05);不同文化程度、是否在基层首次发现血压异常、过去1年内接受不同随访服务次数的高血压患者总体服务满意度比较,差异有统计学意义(P<0.05)。结论高血压患者的国家基本公共卫生服务自评受益率及满意度较高,应注重国家基本公共卫生服务的规范提供及城乡同质化,以促进国家基本公共卫生服务实现高质量、可持续的发展。

Background Launched in 2009,the National Essential Public Health Service Program has been conducted for 13 years.Among which the antihypertensive care ranks first among all types of antihypertensive care in terms of population coverage in China.To promote the sustainable development of the National Essential Public Health Services(NEPHSs),it is important to understand the feedback of hypertensive population on the antihypertensive care.Objective To explore hypertension patients'self-rated improvement gained from and satisfaction with the NEPHSs and associated factors,providing a scientific basis for promoting the quality development of the services.Methods By use of multi-stage stratified sampling,2419 hypertensive patients(≥35 years old)were selected from 20 community(township)health centers in 10 districts(counties)of 5 cities in eastern,central and western China from November to December 2019.A questionnaire survey was conducted with them for understanding their general demographic information and management of hypertension.Results The prevalence of having self-rated health improvement associated with the NEPHSs in the survey respondents was 86.26%(2072/2402).The prevalence of self-reported satisfaction with healthcare workers'attitudes toward patients,and their care quality,physical examination,health education,TCM treatment,follow-up service,screening for hypertension complications,blood pressure control effect and overall services was 97.15%(2 349/2 418),94.09%(2 275/2 418),88.16%(2 129/2 415),87.81% (2 118/2 412),61.36%(1 469/2 394),95.04%(2 297/2 417),83.67%(2 013/2 406),82.34%(1 981/2 406), and 95.53%(2 310/2 418),respectively. The prevalence of self-rated improvement gained from the NEPHSs varied significantly by education level,self-rated health,prevalence of blood pressure abnormalities first detected in primary care,and the number of different follow-up services received within the past year(P<0.05). The prevalence of self-reported satisfaction with overall services differed significantly by education level,prevalence of blood pressure abnormalities first detected in primary care, and the number of different follow-up services received within the past year(P<0.05). Conclusion The prevalence of self-rated improvement gained from and self-reported satisfaction with the NEPHSs in hypertension patients were high on the whole. To promote the sound and sustainable development of these services,priority should be given to the standardization of the provision of NEPHSs and the homogeneity of NEPHSs provided to both urban and rural areas.