契约式管理对从化市社区高血压患者的管理效果观察

Effect of contractual management in community hypertension management around Chengjiao sub-district of Conghua District

目的探讨契约式管理对从化市城郊社区高血压患者的应用效果。方法选取从化市社区卫生服务中心2010年以来已确诊建档的高血压患者211例作为契约组,均签订健康保健协议;同时按照匹配原则选择高血压患者209例作为对照组,继续用常规高血压三级管理模式管理;两组均进行为期1年的高血压管理。比较两组血压控制率、自我管理能力、服药率、高血压知识知晓率、健康行为形成率等。采用SPSS17.0统计软件。计量资料采用(xˉ±s)表示,比较采用两独立样本t检验;计数资料比较采用χ2或Z检验。P<0.05为差异有统计学意义。结果两组干预后规律测压及经常与医生交流病情者例数、高血压知识知晓率均较干预前增加(P均<0.05),且契约组效果更显著(P均<0.01)。两组干预后酗酒、高盐摄入、精神紧张发生率均降低(P均<0.05),参加体育锻炼及控制体质量的患者例数均增加(P均<0.05),且契约组效果更显著(P<0.05或<0.01)。两组干预后服药率及血压控制率均高于干预前(P均<0.05),且契约组效果更显著(P均<0.01)。结论契约式管理对从化市城郊社区高血压患者的管理效果较好,且效果优于高血压的常规三级管理模式。

Objective To discuss the effect of contractual management on hypertensive patients in Chenjiao subdistrict of Conghua City. Methods 211 hypertensive patients, who had already been diagnosed and filed in Conghua community healthy service center, were selected to sign health care agreement as contractual group, and 209 hypertensive patients were applied with the traditional three-level management as matched group. Both of two groups were conducted management of hypertension. After a year, blood pressure control rates, ability of self-control, rate of medication, hypertension knowledge and awareness, health behavior formation rate, etc of two groups were compared. In this paper, SPSS17.0 was utilized to analyze the data, measurement data was indicated based on xˉ±s, two independent samples t-test was utilized for comparison, χ2or Z test was for the comparison of measurement data,P<0.05 was considered to be statistically meaningful. Results Both groups were improved obviously in the regularity ration of pressure test and the ratio of communicating with doctors(P<0.05), and contractual group was more obvious(P<0.05). Futhermore, the occurance of excessive drinking, high-salt englobement and nervousness decreased significantly(P<0.05), and the patients doing exercises and controlling weight increased(P<0.05), and contractual group was more obvious than matched group(P<0.05 or <0.01). In addition, both of two group was better than before in medication rate and blood pressure control rate(P<0.05), and contractual group was also more obvious(P<0.01). Conclusions Contractual management has better effect in hypertension patients than traditional three level management Chengjiao sub-district of Conghua City.