CAJ | 학술논문

目的探讨社区规范化管理对高血压的防治效果及其经济学意义.方法 2010年10月至2011年9月,我们采用前瞻性对照设计,在常平镇按随机数字表法随机抽取4个社区(土塘、桥梓、桥沥、田尾)进行筛查,确诊高血压患者439例.随社区分为干预组(2个社区,221例)、对照组(2个社区,218例).干预组根据“中国高血压防治指南(2009年基层版)”采取规范化管理,对照组采取常规管理.结果 ①1年后,共412例进入分析,包括干预组216例、对照组196例.干预组管理后治疗率为89.35％、控制率为65.74％,分别高于管理前的38.01％、13.12,干预前后比较差异均有统计学意义(x2=124.11、126.99,P均＜0.001).对照组管理后治疗率为65.31％、控制率为40.31％,高于管理前的37.62％、13.76％,管理前后比较,差异均有统计学意义(x2=31.71、37.51,P均＜0.001).②干预组每提高1％的治疗率,所需人均管理成本比对照组少投入1.09元；干预组每提高1％的控制率所需人均管理成本比对照组少投入1.37元.干预组管理后治疗率、控制率均高于对照组(x2=34.53、26.74,P均＜0.001).③干预组人均管理成本为176.43元,高于对照组(125.33元)；干预组人均综合费用为1403.98元,低于对照组(1791.32元).干预组人均管理成本每增加1元,可减少各项综合费用7.58元(个人费用3.98元、社保负担费用3.60元).结论社区规范化管理可提高高血压病的防治效果,具有较好的成本-效果比,可节省社会资源.
목적 탐토사구규범화관리대고혈압적방치효과급기경제학의의.방법 2010년10월지2011년9월,아문채용전첨성대조설계,재상평진안수궤수자표법수궤추취4개사구(토당、교재、교력、전미)진행사사,학진고혈압환자439례.수사구분위간예조(2개사구,221례)、대조조(2개사구,218례).간예조근거“중국고혈압방치지남(2009년기층판)”채취규범화관리,대조조채취상규관리.결과 ①1년후,공412례진입분석,포괄간예조216례、대조조196례.간예조관리후치료솔위89.35％、공제솔위65.74％,분별고우관리전적38.01％、13.12,간예전후비교차이균유통계학의의(x2=124.11、126.99,P균＜0.001).대조조관리후치료솔위65.31％、공제솔위40.31％,고우관리전적37.62％、13.76％,관리전후비교,차이균유통계학의의(x2=31.71、37.51,P균＜0.001).②간예조매제고1％적치료솔,소수인균관리성본비대조조소투입1.09원；간예조매제고1％적공제솔소수인균관리성본비대조조소투입1.37원.간예조관리후치료솔、공제솔균고우대조조(x2=34.53、26.74,P균＜0.001).③간예조인균관리성본위176.43원,고우대조조(125.33원)；간예조인균종합비용위1403.98원,저우대조조(1791.32원).간예조인균관리성본매증가1원,가감소각항종합비용7.58원(개인비용3.98원、사보부담비용3.60원).결론 사구규범화관리가제고고혈압병적방치효과,구유교호적성본-효과비,가절성사회자원.
Objective To discuss the effectiveness of standardized management of hypertension and its significance of economics.Methods Taking prospective,randomized and controlled trial design to screen hypertension in four communities of Changping Town.The patients in the four communities were randomly divided into an intervention group and a control group.The intervention group was taken the standardized management and the control group was taken conventional management.Results The treatment rate and control rate of the intervention group was higher than the control group.Necessary inputs of per capita administration costs for every 1％ increase of treatment or control rate in the intervention group were less than the control groups by 1.08 and 1.36 Yuan respectively.The per capita administrative costs of intervention group were higher than control group,while the per capita comprehensive costs of intervention group were lower than control group.Compared with the control group,every 1 Yuan of per capita administrative costs increases,the comprehensive costs would be reduced 7.58 Yuan in the intervention group.Conclusion Standardized management of hypertension in community can significantly improve the prevention and treatment effects.Moreover,it has good cost-effective value and saving social resources.