福建省农村地区慢性病管理实施进展分析

目的了解基本公共卫生服务项目实施以来福建省农村地区慢性病管理的进展情况。方法 2009和2011年采用完全随机抽样方法分别调查了64家和150家乡镇卫生院的慢性病管理实施进展情况,用χ2检验对两年慢性病管理相关指标进行比较,采用SPSS13.0软件包进行统计分析,P〈0.05为差异有统计学意义。结果 2009年51.56%（33/64）和48.44%（31/64）的被调查卫生院开展高血压和糖尿病的建档工作,2011年所有被调查卫生院均已开展该工作,并对患者进行随访管理。2011年被调查乡镇卫生院高血压健康管理率、规范管理率和血压控制率分别为31.13%、79.97%和42.98%,糖尿病健康管理率、规范管理率和血糖控制率分别为29.54%、69.17%和35.69%,均高于2009年,差异有统计学意义（χ2=95 007.06、7 166.39、2 098.09、23 132.96、200.56、191.33,P均〈0.01）。结论 2011年慢性病管理工作已在福建省农村地区全面铺开,但存在惠及的农村人口仍较少和地区发展不平衡等问题。应采取多途径增加发现慢性病患者的机会,使更多的患者纳入管理。明确乡镇卫生院的公共卫生职能定位,建立机构内绩效考核机制,促进地区间的协调发展。

Progress on chronic disease management in rural areas of Fujian province

Objective To assess the improvement of chronic disease management in rural areas of Fujian after the implementation of basic public health services project. Methods A total of 64and 150county hospitals were randomly selected and surveyed separately in 2009and 2011for the progress made on chronic disease management,and related indicators were compared and analyzed statistically using SPSS 13.0software. Results In 2009,only around half of surveyed county hospitals had documentation of patients with hypertension（51.56%）and diabetes（48.44%）.However,both were up to 100%（150/150）2years later.Meanwhile, in 2011,the health management rate,standard management rate,blood pressure and blood sugar control rates were all significantly higher for patients with hypertension and diabetes compared to those in 2009（P〈0.01）. Conclusions Chronic disease management work is improved greatly in rural areas in Fujian in 2011.However,because of the unbalanced development of rural areas,multiple ways need to be applied in order to find patients with chronic diseases and manage them well.