医院-社区-家庭-个人的慢阻肺防控体系对慢阻肺患病率、知晓率及准确性的影响

Study on the impact of hospital-community-home-person integrated COPD prevention and control system on COPD incidence rate awareness and accuracy

目的 在社区基层中实施医院-社区-家庭-个人的慢性阻塞性肺疾病(简称慢阻肺)防控体系,就该体系对慢阻肺患病率、知晓率及准确性的影响进行研究。方法 2022年1—12月在中山火炬开发区人民医院和中山市三角、东区等14个镇区社区卫生服务中心选取年龄≥40岁的1 000例居民为此次研究对象,按时间顺序将研究对象分为实施前(2022年1—6月实施常规管理,共500名居民)、实施后(2022年7—12月在常规管理上实施医院-社区-家庭-个人的慢阻肺防控体系,共500名居民)。对比实施前、实施后慢阻肺患病率、慢阻肺筛查准确性、慢阻肺知晓率;同时对比实施前、实施后早期发现慢阻肺患者的急性发作频率、住院次数和总体医疗费用。结果 实施后居民的慢阻肺患病率低于实施前,其慢阻肺筛查准确性高于实施前(P<0.05)。实施后居民对慢阻肺知识、用药知识、疾病防治知识和日常生活注意事项知晓率均高于实施前(P<0.05)。实施后早期发现慢阻肺患者的急性发作频率低于实施前,其住院次数和总体医疗费用少于实施前(P<0.05)。结论 实施医院-社区-家庭-个人的慢阻肺防控体系,能有效降低≥40岁居民的慢阻肺患病率,提高慢阻肺筛查准确性和居民对慢阻肺的知晓率,且通过筛查确诊为慢阻肺后通过该体系的干预能有效减少患者的急性发作频率,减少其住院次数和医疗费用。

Objective To investigate the impact of the hospital-community-home-person integrated chronic obstructive pulmonary disease(COPD)prevention and control system on the COPD incidence rate,awareness,and accuracy within a community-based setting.Methods From January 2022 to December 2022,a total of 1000 residents aged≥40 years were selected from Zhongshan Torch Development Zone People′s Hospital and 14 community health service centers in districts such as Sanjiao and Dongqu,Zhongshan.The participants were divided chronologically into pre-implementation(500 residents,receiving routine management from January to June 2022)and post-implementation(500 residents,receiving hospital-community-home-person integrated COPD prevention and control system on top of routine management from July to December 2022)groups.COPD incidence rate,accuracy of COPD screening,COPD awareness,as well as the frequency of acute exacerbations,hospital admissions,and total medical costs of COPD patients were compared between pre-implementation and post-implementation phases.Results After implementation,the COPD incidence rate among residents decreased compared to pre-implementation,and the accuracy of COPD screening was higher(P<0.05).Post-implementation,residents′awareness of COPD knowledge,medication knowledge,disease prevention and management knowledge,and daily life precautions was significantly higher compared to pre-implementation(P<0.05).The frequency of acute exacerbations,hospital admissions,and total medical costs of COPD patients detected early were lower after implementation(P<0.05).Conclusion Implementing the hospital-community-home-person integrated COPD prevention and control system effectively reduces the COPD incidence rate among residents aged≥40 years,enhances the accuracy of COPD screening and residents′awareness of COPD.Additionally,the intervention within this system,post COPD diagnosis through screening,significantly decreases the frequency of acute exacerbations,hospital admissions,and medical costs for patients.