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目的:评估上海社区高血压疾病细节管理的成本效果,为建立和推广高血压预防和控制的模式提供依据。方法:资料来自上海市区4个社区1 442名高血压病患者1年干预的随访。以血压水平和血压达标为效果指标,测算项目的管理成本和人力劳务成本,采用成本效果比方法估计社区高血压综合干预的成本效果。结果:经过管理分摊,干预组和日常管理组每年每管理1个高血压患者的成本分别是968.8元和740.6元。成本效果分析显示,与日常管理组相比,干预组每降低1 mmHg(0.133kPa)的收缩压可少花费44.51元,每降低1 mmHg舒张压可少花费82.52元,每提高1个百分点的血压控制达标率可少花费9.63元。结论:本次社区高血压非药物综合性干预项目比日常管理更加节省卫生资源。
Objective: To evaluate the cost effectiveness of detail management of hypertension in Shanghai community, and to provide the basis for establishing and popularizing the prevention and control of hypertension. Methods: The data were obtained from 1 442 hypertensive patients in 4 communities in Shanghai area for 1-year follow-up. Taking the blood pressure and blood pressure as the standard, the project management cost and labor cost were estimated, and the cost-effectiveness method was used to estimate the cost effect of community-based hypertension intervention. Results: After management apportion, the cost of managing one hypertensive patient per year per year was respectively 968.8 yuan and 740.6 yuan in the intervention group and the daily management group. Cost-effectiveness analysis showed that for every 1 mmHg (0.133 kPa) reduction in systolic pressure in the intervention group, the intervention cost 44.51 yuan less, and diastolic blood pressure decreased by 82.52 yuan for every 1 mmHg reduction. For each 1% increase in blood pressure Control compliance rate can cost 9.63 yuan. Conclusion: The community non-drug hypertension comprehensive intervention project saves more health resources than the routine management.