基于慢性病一体化门诊的高血压病数智化医防融合管理效果分析

Analysis of the effectiveness of digitized management in integrated medical and preventive care for hypertension through chronic diseases outpatient services

目的分析基于慢性病一体化门诊的高血压病数智化医防融合管理的效果,为基层高血压病管理提供参考。方法2021年9月选取凯旋街道社区卫生服务中心门诊中年龄为35~79岁的高血压患者772例,按随机数字表法分为干预组(388例)和对照组(384例)。干预组采用基于慢性病一体化门诊的数智化医防融合管理,对照组采用基于全科门诊的常规社区管理。干预18个月后统计分析2组患者干预前后生活方式的变化,血压和血压血糖血脂联合达标率的变化,以及研究终点时血压达标的影响因素。结果干预后干预组的饮酒[18.8%(73例)]、肥胖[5.4%(21例)]、腹型肥胖率[31.2%(121例)]改善,与对照组[27.1%(104例)、11.7%(45例)、45.1%(173例)]比较,差异均有统计学意义(χ^(2)=7.468、19.627、15.738,P<0.05);干预组的血压和血压血糖血脂联合达标率[61.9%(240例)、53.4%(207例)]均高于对照组[44.3%(170例)、28.1%(108例)],差异有统计学意义(χ^(2)=23.964、50.843,P<0.05);多因素logistic回归分析显示,接受数智化医防融合管理(OR=1.587,95%CI:1.161~2.171)、血糖达标(OR=2.056,95%CI:1.294~3.266)、血脂达标(OR=1.490,95%CI:1.042~2.131)均是血压达标的独立促进因素(P<0.05)。结论基于慢性病一体化门诊的数智化医防融合管理有助于提高高血压病的管理效果。

Objective To enhance hypertension management in primary medical institutions by analyzing the effectiveness of digitized management of medical-preventive integration for hypertension based on integrated outpatient services for chronic diseases.Methods In September 2021,772 hypertensive patients aged 35-79 were selected from the outpatient department of Kaixuan Subdistrict Community Healthcare Center.According to the random principle,388 cases were assigned to the intervention group and 384 to the control group.The intervention group adopted digitized management of medical-preventive integration based on integrated outpatient services for chronic diseases,while the control group adopted a routine community hypertension management based on general outpatient services.After 18 months of intervention,statistical analysis assessed changes in lifestyle,blood pressure compliance rate,and combined compliance rats for blood pressure,blood glucose,and lipid levels in both groups before and after intervention.Factors influencing blood pressure compliance at the study endpoint were also analyzed.Results Following the intervention,the alcohol consumption,obesity,and abdominal obesity rates in the intervention group were improved[18.8%(73 cases)vs.27.1%(104 cases),5.4%(21 cases)vs.11.7%(45 cases),31.2%(121 cases)vs.45.1%(173 cases),respectively],which were statistically significant compared to the control group(χ^(2)=7.468,19.627,15.738,P<0.05).The blood pressure compliance rate and the combined compliance rate of blood pressure,blood glucose,and lipid in the intervention group[61.9%(240 cases)and 53.4%(207 cases),respectively]were higher than those in the control group[44.3%(170 cases)and 28.1%(108 cases),respectively],with statistically significant(χ^(2)=23.964,50.843,P<0.05).Multivariate logistic regression analysis showed that receiving digital integrated medical and preventive management(OR=1.587,95%CI:1.161-2.171),blood glucose control(OR=2.056,95%CI:1.294-3.266),and blood lipid control(OR=1.490,95%CI:1.042-2.131)were independent promoting factors for blood pressure control(P<0.05).Conclusion The digitized management of medical-preventive integration based on integrated chronic disease outpatient services can improve the effectiveness of blood pressure disease management.