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目的探索家庭医生签约服务对社区老年人健康状况的影响。方法以参加广州市花都区某社区卫生服务中心2016年3月免费体检的65岁及以上老年人为研究对象,以自愿签约家庭医生服务的老年人为签约组,未签约家庭医生服务的老年人为对照组。签约组由家庭医生服务团队进行管理,对照组由公卫医师进行常规随访管理。分别于签约干预前和干预1年后检测2组人群的体质指数、血压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇含量并进行比较。采用logistic回归分析方法进行相关影响因素分析。结果共调查304人,其中签约组170人,对照组134人。签约干预前2组对象的体质指数、血压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇异常率差异均无统计学意义(均P>0.05)。签约干预后,除体质指数外,签约组的血压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇异常率均低于对照组,差异均有统计学意义(均P<0.05)。Logistic回归分析结果显示,家庭医生签约服务是血压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇的影响因素。结论家庭医生签约服务能提高老年人血压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇的正常率,有效改善老年人的健康状况。
Objective To explore the impact of family doctor service on the health status of the elderly in community. Methods Participants aged 65 and over in a free medical examination in a community health service center in Huadu District of Guangzhou City in March 2016 were selected as the research objects. Elderly people who volunteered for signing a family doctor served as the contracting group and the elderly who did not sign up for a family doctor as the reference group. The contracted group was managed by the family doctor service team, and the control group was routinely followed by the public health clinic. Body mass index, blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol in two groups before and after one-year intervention were measured and compared. Logistic regression analysis was used to analyze the influencing factors. Results A total of 304 investigated, including 170 contracted groups, control group of 134 people. Body mass index, blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol, and high density lipoprotein cholesterol in the two groups before signing the intervention were not significantly different (all P> 0.05). After signing the intervention, except the body mass index, the abnormal blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol in the contracted group were lower than those in the control group All P <0.05). Logistic regression analysis showed that family doctor signing service was the influencing factor of blood pressure, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol. Conclusion Family doctor signing service can improve the normal rate of blood pressure, fasting blood glucose, triglyceride and high density lipoprotein cholesterol in the elderly and effectively improve the health of the elderly.