2021年江西省高血压和糖尿病患者管理服务现状分析

Health management of hypertension and diabetes patients in Jiangxi Province in 2021

目的了解江西省慢性病中高血压和糖尿病患者健康管理服务现状,并研究在管理过程中存在的不足及原因,为综合提升健康服务水平提供有力支持。方法按照分层随机抽样方法,在全省11个市118个县中抽取56个县,在每个县的电子档案系统里等距抽取慢性病患者健康档案各10份进行电话问卷调查,核实电子档案信息和各种检查记录,依据国家规范判定档案信息真实性和服务规范性,计算血压/血糖控制率,分析血压/血糖控制情况。结果高血压患者档案信息真实率为87.5%、服务规范率为61.4%、血压控制率为61.1%,而糖尿病患者分别为88.9%、60.8%、55.4%。健康管理服务的不规范项具体情况如下:不知道/未通知是患者未体检或未随访的最主要原因,占比分别为78.0%和79.5%;未进行健康指导是服务内容不规范的主要因素,占比为35.6%;BMI≥24者未指导减体重是未进行健康指导的主要因素,占比为57.0%;用药情况是随访记录存在空漏错项中的主要因素,占比为34.1%。高血压患者和糖尿病患者对服务的满意度分别为79.0%、79.5%。结论江西省高血压和糖尿病患者档案服务规范性基本达标,但仍需加强管理服务工作,服务满意度还需进一步提升。

Objective To explore the current status of health management of patients with hypertension and diabetes in Jiangxi Province,and to study the deficiencies and causes in the management process,so as to provide a strong basis for comprehensively improving the level of health services.Methods The stratified random sampling method was used to select 56 counties out of 118 counties in 11 cities of the province,and 10 health records of patients with chronic diseases were equally selected from the electronic file system of each county for telephone questionnaire survey.Electronic file information and various examination records were verified,and the authenticity of file information and service standardization was determined according to national norms,then blood pressure/blood glucose control rate was calculated,and status quo of blood pressure/blood glucose control was analyzed.Results The accuracy rate of information,service standard rate and blood pressure control rate of hypertension patients were 87.5%,61.4%and 61.1%,respectively,while those of diabetes patients were 88.9%,60.8%and 55.4%,respectively.The non-standard items of health management services were as follows:not knowing/not being informed was the most important reason for patients not having physical examination and not being followed up,accounting for 78.0%and 79.5%,respectively.Lack of health guidance was the main factor for non-standard service content,accounting for 35.6%.For those with BMI≥24,having no guidancein weight loss was the main factor for unguided health care,accounting for 57.0%.Medication use was the main factor for missing and incorrect information in follow-up records,accounting for 34.1%.The satisfaction rates of hypertension and diabetes patients were 79.0%and 79.5%,respectively.Conclusions The file mangement for patients with hypertension and diabetes in Jiangxi Province has basically reached the standard,but the management and service work still needs to be strengthened,and the service satisfaction needs to be further improved.