中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
13期
1547-1550
,共4页
王皎%姜明霞%孙利华%陈璟瑜%陆胤%季一薇%鲍勇
王皎%薑明霞%孫利華%陳璟瑜%陸胤%季一薇%鮑勇
왕교%강명하%손리화%진경유%륙윤%계일미%포용
家庭医生签约服务%贫困老人%健康管理
傢庭醫生籤約服務%貧睏老人%健康管理
가정의생첨약복무%빈곤노인%건강관리
Family doctor contracted services%Poor elderly%Health management
目的:评价家庭医生签约服务对改善城市贫困老人健康状况、卫生服务利用、管理依从性的效果。方法按2∶1原则从上海某街道12个居委中随机抽取8个居委为干预组,剩余4个居委为对照组,每个居委会抽取25名愿意参加研究的贫困老人,最终确定的样本数量干预组200人,对照组100人。2012-06-30通过基线调查,了解贫困老人的人口学特征、健康状况、卫生服务利用、管理依从性等。随后,干预组通过签订家庭医生制服务协议,提供个性化家庭医生服务,对照组仅进行常规健康随访。18个月后进行效果调查,了解干预组和对照组以上指标的变化,对干预措施进行评价。结果共274人完成研究,其中干预组181人,对照组93人。基线调查时贫困老人高血压、糖尿病的控制率分别为74.1%(203人)、79.9%(219人),其中干预组分别为82.3%(149人)、86.7%(157人),对照组分别为58.1%(54人)、66.7%(62人),差异均有统计学意义(P ﹤0.05);效果调查时贫困老人高血压、糖尿病的控制率分别为73.4%(201人)、73.0%(200人),其中干预组分别为81.8%(148人)、82.3%(149人),对照组分别为57.0%(53人)、54.8%(51人),差异亦有统计学意义(P ﹤0.05)。基线调查时73.0%(200人)的贫困老人愿意改变生活行为方式或健康检查等措施预防高血压,其中干预组为74.6%(135人),对照组为69.9%(65人),差异无统计学意义(P ﹥0.05);效果调查时92.0%(252人)的贫困老人愿意改变生活行为方式或健康检查等措施预防高血压,其中干预组为96.7%(175人),对照组为82.8%(77人),差异有统计学意义( P ﹤0.05)。基线调查时24.8%(68人)的贫困老人对家庭医生制服务满意,其中干预组为26.5%(48人),对照组为21.5%(20人),差异无统计学意义(P ﹥0.05);效果调查时89.8%(246人)的贫困老人对家庭医生制服务满意,其中干预组为97.8%(177人),对照组为74.2%(69人),差异有统计学意义(P ﹤0.05)。结论家庭医生制服务对提高社区贫困老人的慢性病控制率、健康管理依从性有一定的效果。
目的:評價傢庭醫生籤約服務對改善城市貧睏老人健康狀況、衛生服務利用、管理依從性的效果。方法按2∶1原則從上海某街道12箇居委中隨機抽取8箇居委為榦預組,剩餘4箇居委為對照組,每箇居委會抽取25名願意參加研究的貧睏老人,最終確定的樣本數量榦預組200人,對照組100人。2012-06-30通過基線調查,瞭解貧睏老人的人口學特徵、健康狀況、衛生服務利用、管理依從性等。隨後,榦預組通過籤訂傢庭醫生製服務協議,提供箇性化傢庭醫生服務,對照組僅進行常規健康隨訪。18箇月後進行效果調查,瞭解榦預組和對照組以上指標的變化,對榦預措施進行評價。結果共274人完成研究,其中榦預組181人,對照組93人。基線調查時貧睏老人高血壓、糖尿病的控製率分彆為74.1%(203人)、79.9%(219人),其中榦預組分彆為82.3%(149人)、86.7%(157人),對照組分彆為58.1%(54人)、66.7%(62人),差異均有統計學意義(P ﹤0.05);效果調查時貧睏老人高血壓、糖尿病的控製率分彆為73.4%(201人)、73.0%(200人),其中榦預組分彆為81.8%(148人)、82.3%(149人),對照組分彆為57.0%(53人)、54.8%(51人),差異亦有統計學意義(P ﹤0.05)。基線調查時73.0%(200人)的貧睏老人願意改變生活行為方式或健康檢查等措施預防高血壓,其中榦預組為74.6%(135人),對照組為69.9%(65人),差異無統計學意義(P ﹥0.05);效果調查時92.0%(252人)的貧睏老人願意改變生活行為方式或健康檢查等措施預防高血壓,其中榦預組為96.7%(175人),對照組為82.8%(77人),差異有統計學意義( P ﹤0.05)。基線調查時24.8%(68人)的貧睏老人對傢庭醫生製服務滿意,其中榦預組為26.5%(48人),對照組為21.5%(20人),差異無統計學意義(P ﹥0.05);效果調查時89.8%(246人)的貧睏老人對傢庭醫生製服務滿意,其中榦預組為97.8%(177人),對照組為74.2%(69人),差異有統計學意義(P ﹤0.05)。結論傢庭醫生製服務對提高社區貧睏老人的慢性病控製率、健康管理依從性有一定的效果。
목적:평개가정의생첨약복무대개선성시빈곤노인건강상황、위생복무이용、관리의종성적효과。방법안2∶1원칙종상해모가도12개거위중수궤추취8개거위위간예조,잉여4개거위위대조조,매개거위회추취25명원의삼가연구적빈곤노인,최종학정적양본수량간예조200인,대조조100인。2012-06-30통과기선조사,료해빈곤노인적인구학특정、건강상황、위생복무이용、관리의종성등。수후,간예조통과첨정가정의생제복무협의,제공개성화가정의생복무,대조조부진행상규건강수방。18개월후진행효과조사,료해간예조화대조조이상지표적변화,대간예조시진행평개。결과공274인완성연구,기중간예조181인,대조조93인。기선조사시빈곤노인고혈압、당뇨병적공제솔분별위74.1%(203인)、79.9%(219인),기중간예조분별위82.3%(149인)、86.7%(157인),대조조분별위58.1%(54인)、66.7%(62인),차이균유통계학의의(P ﹤0.05);효과조사시빈곤노인고혈압、당뇨병적공제솔분별위73.4%(201인)、73.0%(200인),기중간예조분별위81.8%(148인)、82.3%(149인),대조조분별위57.0%(53인)、54.8%(51인),차이역유통계학의의(P ﹤0.05)。기선조사시73.0%(200인)적빈곤노인원의개변생활행위방식혹건강검사등조시예방고혈압,기중간예조위74.6%(135인),대조조위69.9%(65인),차이무통계학의의(P ﹥0.05);효과조사시92.0%(252인)적빈곤노인원의개변생활행위방식혹건강검사등조시예방고혈압,기중간예조위96.7%(175인),대조조위82.8%(77인),차이유통계학의의( P ﹤0.05)。기선조사시24.8%(68인)적빈곤노인대가정의생제복무만의,기중간예조위26.5%(48인),대조조위21.5%(20인),차이무통계학의의(P ﹥0.05);효과조사시89.8%(246인)적빈곤노인대가정의생제복무만의,기중간예조위97.8%(177인),대조조위74.2%(69인),차이유통계학의의(P ﹤0.05)。결론가정의생제복무대제고사구빈곤노인적만성병공제솔、건강관리의종성유일정적효과。
Objective To evaluate the effect of family doctor service on the improvement of the health condition of the poor elderly in the city,the utilization of health resources and the management compliance. Methods According to the principle of 2∶ 1,8 residents committees were randomly chosen from 12 ones in a community of Shanghai City as intervention group,anther 4 ones as the control group,then 25 urban poor elderly in each committee were recruited by cluster sampling,so eventually there were 200 samples in the intervention group( n = 200)and 100 in the control group( n = 100). By the baseline survey,all these samples were investigated about the demographic characteristics,health status,health service utilization,the management compliance of the urban poor elderly. Then,the intervention group was provided with personalized family doctor service according to the service agreement signed with community health center while the control group received only regular heath follow - up. 18 months later,effect survey was conducted to understand the changes of the previous indexes of intervention group and control group and evaluate the intervention measure. Results Totally 274 samples finished the survey including 181 in the intervention group and 93 in the control group. In the baseline survey,the control rates of hypertension and diabetes were 74. 1% (n = 203), 79. 9% (n = 219)and they were 82. 3% (n = 149),86. 7% (n = 157)in the intervention and 58. 1% (n = 54),66. 7%(n = 62)in the control group. All the difference were significant(P ﹤ 0. 05). In the effect survey,the control rates of hyper-tension and diabetes were 73. 4% (n = 201),73. 0% (n = 200) and they were 81. 8% (n = 148),82. 3% (n = 149) in the intervention and 57. 0% (n = 53),54. 8% (n = 51) in the control group. All the difference were also significant( P ﹤0. 05). As to the number of the elderly who were willing to change their lifestyle and receive health examination etc to prevent high blood pressure,in the baseline survey,there were 200(73. 0% ),including 135 in the intervention(74. 6% )and 65 (69. 9% )in the control,no significant difference(P ﹥ 0. 05);in the effect evaluation survey,there were 252( 92. 0% ), including 175(96. 7% )in the intervention and 77(82. 8% )in the control,with significant difference( P ﹤ 0. 05). In the baseline survey,24. 8% (n = 68)of the elderly were satisfied with the family doctors′ service,including 26. 5% (n = 48)in the intervention and 21. 5% (n = 20)in the control while in the effect evaluation survey,the figure was 89. 8% (n = 246)in-cluding 97. 8% (n = 177)in the intervention and 74. 2% (n = 69) in the control,with significant difference(P ﹤ 0. 05). Conclusion Family physician service mode has certain effect on the control rate of some chronic diseases and the health manage-ment compliance of the urban poor elderly.