北京农村慢性病防治能力调查

Survey of the Ability for Chronic Disease Prevention and Control in Rural of Beijing

目的 评价北京郊区农村开展慢性病防治的能力。方法 对昌平、顺义、房山、大兴卫生局疾病控制科及健康教育负责人员进行个人访谈 ,对 4个区 76名区医院内科医生、193名镇 (乡 )医院医生、37个镇 (乡 )医院领导进行问卷调查。结果 4个区前 5位死因顺位依次是脑血管疾病、心脏病、呼吸系统疾病、恶性肿瘤、损伤和中毒 ;区卫生局和疾病控制中心设立了疾病控制科或慢性病防治职能科室 ;慢性病防治费用最多为 16万元 ,最低 10万元。平均每个镇医院有医生 2 5人 ,护士 5人 ;医生中 36 %具有专科以上学历 ;平均拥有病床 2 7张 ;10 0 %镇医院拥有血压计、心电图、X线、B超、救护车 ,84 %镇医院具有生化分析设备。除血脂异常诊断标准镇 (乡 )卫生院医生回答正确率高于区医院医生外 ,高血压、糖尿病、冠心病、血脂异常其它相关知识正确回答率区医院医生和镇 (乡 )医院医生没有显著差别。高血压危险因素、高血压药物治疗原则、2型糖尿病主要危险因素、冠心病危险因素等知识正确回答率偏低。结论 在机构、人力资源、医疗设施等方面农村具有开展慢性病防治的能力 ,但卫生投入不足 ,医疗保健制度不完善 ,人力资源培训还需加强。

Objective To evaluation the ability for chronic disease prevention and control in rural of Beijing rural area.Method Those people were investigated with questionnaire,they were 8 directors of disease control and health education departments from Changping district,Shunyi district,Fangshan district,37 heads of town hospitals,76 internists from the district hospitals and 193 internists from the town hospitals.Results The leading death causes of four districts were cerebrovascular disease,cardiovascular disease,respiratory disease,cancer,and injury respectively.Health Bureau of district set up department of disease control.The highest fund for chronic disease prevention and control was up to 160 000 Yuan and the lowest was 100 000 Yuan.The average numbers were 25 doctors and 5 nurses per hospital,over 36% of doctors had college certificate.There were 27 beds per hospital.All the town hospitals had sphygmomanometer,ECG,X-ray,ambulance.84% town hospitals had biochemical instruments.There were no significant differences in the right response rates about hypertension,diabetes and coronary heart disease between doctors of the district and town hospitals,except the standard town hospitals who had high correct rate on dyslipoproteinemia than district ones.The right response rates about risk factors for hypertension,the discipline of cure with medicine,risk factors for type 2 diabetes were lower.Conclusions Rural has the ability of chronic disease prevention and control in organization structure,human resources and medical instruments.But health resource is insufficient,the medical insurance is not perfectible and training on health staff should be strengthened.