CAJ | 학술논문

目的：通过对高血压患者的社区健康管理，确定高血压社区健康管理模式的投入与产出，改变高血压患者的知信行，提出降低乌鲁木齐市高血压病患者降压治疗费用的合理建议。方法随机整群抽取乌鲁木齐市两所社区18岁以上患高血压病常住居民809例进行连续1年的社区健康管理，按随机数字表法随机将南湖二附院社区分为观察组，第二济困医院社区分为对照组，其中观察组414例，对照组395例；研究两组患者知识行为改变、治疗费用等情况，分析高血压健康管理成本效益。结果两组患者高血压知识及行为改变情况比较，观察组血压分级、超重肥胖知识知晓率分别为17．94％，43．10％，高于对照组（3．04％，29．77％），差异有统计学意义（χ2值分别为-5．688，15．608；P＜0．01）；观察组正常血压范围、危险因素知晓情况优于观察组，差异有统计学意义（ Z值分别为-11．927，-17．677；P ＜0.01）。两组患者治疗费用比较，观察组全部患者药物治疗费用、住院患者平均住院费用分别为（1583．88±981．24），（10725．77±11688．26）元，均少于对照组，差异有统计学意义（ t值分别为2．14，2.75；P＜0．05）；观察组服药患者药物治疗费用、其他费用均低于对照组，差异均有统计学意义（P＜0.01）。结论高血压社区健康管理能取得较好成本效益，是降低高血压病成本、提高高血压病患者生命质量的重要举措。
목적：통과대고혈압환자적사구건강관리，학정고혈압사구건강관리모식적투입여산출，개변고혈압환자적지신행，제출강저오로목제시고혈압병환자강압치료비용적합리건의。방법수궤정군추취오로목제시량소사구18세이상환고혈압병상주거민809례진행련속1년적사구건강관리，안수궤수자표법수궤장남호이부원사구분위관찰조，제이제곤의원사구분위대조조，기중관찰조414례，대조조395례；연구량조환자지식행위개변、치료비용등정황，분석고혈압건강관리성본효익。결과량조환자고혈압지식급행위개변정황비교，관찰조혈압분급、초중비반지식지효솔분별위17．94％，43．10％，고우대조조（3．04％，29．77％），차이유통계학의의（χ2치분별위-5．688，15．608；P＜0．01）；관찰조정상혈압범위、위험인소지효정황우우관찰조，차이유통계학의의（ Z치분별위-11．927，-17．677；P ＜0.01）。량조환자치료비용비교，관찰조전부환자약물치료비용、주원환자평균주원비용분별위（1583．88±981．24），（10725．77±11688．26）원，균소우대조조，차이유통계학의의（ t치분별위2．14，2.75；P＜0．05）；관찰조복약환자약물치료비용、기타비용균저우대조조，차이균유통계학의의（P＜0.01）。결론고혈압사구건강관리능취득교호성본효익，시강저고혈압병성본、제고고혈압병환자생명질량적중요거조。
Objective Through the community health management of hypertension , to determine the input and output , change the knowledge , attitude, practice ( KAP) of hypertension patients and put forward the reasonable suggestions of antihypertensive treatment in order to reduce hypertensive patients 'medical expenses . Methods By random cluster sampling method , we selected 809 hypertension patients , over 18 years old, from two communities in Urumqi .414 patients were in the management group and 395 patients were in the control group.The health management the cost benefit was analyzed by the change of patient 's KAP, medical expenses and so on.Results For the knowledge and behavior changes , 17.94% patients in the management group and 3.04%patients in the control knew the classification of blood pressure (Z=-5.688,P=0.000).The master of normal range of blood pressure (Z=-11.927,P=0.000), knowledge of obesity (χ2 =15.608,P=0.000) and knowledge of risk factors (χ2 =-17.677,P=0.000) between groups had significant differences (P<0.01).The total drug expenses of the management group and the control group were (1 583.88 ±981.24) and (1 923.90 ±1 523.81) yuan, respectively;the total hospitalization expenses of the management group and the control group were (10 725.77 ±11 688.26) and (15 327.03 ±10 280.42) yuan, respectively, the differences were significant (t=2.14,2.75, respectively;P<0.05).The costs of patients taking the drug and other costs in the management group were lower than the control group , the differences were significant ( P <0.01 ). Conclusions Hypertension health management can obtain a good cost benefit , reduce hypertension sickness cost, and improve quality of life .