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目的对2015~2016年四川省基本公共卫生服务项目中高血压患者接受基层健康管理服务的情况进行分析,为进一步规范高血压的社区防治工作提供科学依据。方法采取多阶段分层随机抽样方法,在全省分别抽取21个县(区)的42个基层医疗卫生机构开展调查,在每个机构等距抽取高血压患者健康档案各10份开展电话调查,核查档案表单、个人信息、体检记录、随访信息等,根据国家基本公共卫生服务规范设定条件判断档案信息准确性和服务规范性,记录最后一次随访时的血压,并进行分析。结果 2015~2016年,四川省高血压患者健康管理率由42.09%下降到40.31%(χ~2=115.33,P<0.05),健康档案信息准确率由84.29%上升到88.79%(χ~2=1.94,P=0.16),服务规范率由69.49%上升为72.33%(χ~2=0.54,P=0.57),血压控制率由82.66%上升为85.37%(χ~2=0.52,P=0.48),服务规范化可明显提高血压控制率(χ~2=22.61,P<0.05)。结论 2015~2016年四川省高血压患者健康管理服务工作取得一定成效,但仍需进一步提高服务的规范性。
Objective To analyze the situation of accepting primary health care services for hypertensive patients in basic public health service projects in Sichuan province during 2015-2016, and provide scientific evidence for further regulating community prevention and control of hypertension. Methods A multi-stage stratified random sampling method was used to investigate 42 primary health care institutions in 21 counties (districts) across the province. A telephone survey was conducted on 10 isolates of hypertension patients at each institution. Check the archives form, personal information, physical examination records, follow-up information, etc., according to the national basic public health services to determine the conditions set by the file information accuracy and service norms, record the last follow-up of blood pressure and analysis. Results From 2015 to 2016, the health management rate of hypertension patients in Sichuan Province dropped from 42.09% to 40.31% (χ ~ 2 = 115.33, P <0.05), and the accuracy of health records information rose from 84.29% to 88.79% (χ ~ 2 = 1.94, P = 0.16). The service standard rate increased from 69.49% to 72.33% (χ ~ 2 = 0.54, P = 0.57) and the blood pressure control rate increased from 82.66% to 85.37% , Service standardization can significantly improve blood pressure control rate (χ ~ 2 = 22.61, P <0.05). Conclusion The health management services for hypertensive patients in Sichuan Province from 2015 to 2016 have achieved some success, but the standardization of services still needs to be further improved.