重庆市与贵州省基本公共卫生服务NCD健康管理影响因素调查研究

Investigation and study of factors related to NCD health management of basic public health services in Chongqing and Guizhou Province

目的分析重庆市与贵州省慢性非传染性疾病(NCD)健康管理情况及其影响因素。方法采用分层随机抽样,从重庆市和贵州省抽取16个有代表性的基层医疗卫生机构作为研究地点,通过定性和定量研究相结合的方法收集资料。结果共调查760例NCD患者,NCD健康管理项目的知晓率、利用率、满意度均超过84.2%,随访和分类干预的知晓率、利用率、满意度最低。<60岁患者的高血压体检知晓率低于60~<70岁患者(OR=4.28,95%CI:1.43~12.81)和≥70岁患者(OR=3.16,95%CI:1.12~8.91);<60岁患者的糖尿病筛查利用率低于≥70岁患者(OR=2.70,95%CI:1.08~6.76),体检知晓率低于60~<70岁患者(OR=4.24,95%CI:1.01~17.75);重庆市患者的高血压体检知晓率高于贵州省(OR=0.15,95%CI:0.04~0.54),利用情况好于贵州省(OR=0.13,95%CI:0.05~0.34)。访谈结果发现,部分社区未开展分类干预项目,农村患者的满意度高于城市。结论重庆市和贵州省NCD管理服务总体情况较好,但随访和分类干预项目服务质量有待进一步提高。

Objective To analyze the health management situation of non-communicable chronic disease(NCD)in Chongqing City and Guizhou Province and its influencing factors.Methods A stratified random sampling method was used to select 16 representative primary medical and health institutions from Chongqing City and Guizhou Province as the research sites,and the data were collected through the combination method of qualitative and quantitative research.Results A total of 760 patients with NCD were surveyed,and the awareness rate,utilization rate and satisfaction rate of the NCD health management program all exceeded 84.2%,while the awareness rate,utilization rate and satisfaction rate of follow-up and categorical intervention were the lowest.The awareness rate of hypertension physical examination in the patients with<60 years old was lower than that in the patients with 60-<70 years old(OR=4.28,95%CI:1.43-12.81)and the patients with≥70 year sold(OR=3.16,95%CI:1.12-8.91);the utilization rate of diabetes screening in the patients with<60 years-old was lower than that in the patients with≥70 years old(OR=2.70,95%CI:1.08-6.76)and the awareness rate of hypertension physical examination was lower than that of the patients with 60-<70 years old(OR=4.24,95%CI:1.01-17.75);the awareness rate of hypertension physical examination in the patients in Chongqing City was higher than that in Guizhou Province(OR=0.15,95%CI:0.04-0.54)and the utilization situation was better than that in Guizhou Province(OR=0.13,95%CI:0.05-0.34).Conclusion The overall situation of NCD management services in Chongqing City and Guizhou Province is good,but the service quality of follow-up and classified intervention projects needs to be further improved.