高血压病社区防治的绩效考核指标研究

目的：分析确定高血压社区防治绩效考核指标和分值匹配,探讨高血压社区控制的评价方法。方法：采用分层整群抽样的方法,对样本区内社区卫生服务中心所有医务人员和主管部门相关人员进行问卷调查。结果：①96.5%（248人）的调查对象认为高血压应列入社区控制疾病;②高血压社区控制管理指标实际控制水平：≥35岁首诊测压率76.02%、检出率39.09%、登记率80.28%、建档率76.28%、治疗率69.56%、知识知晓率62.70%、高血压知晓率70.28%、控制率53.75%、随访率74.76%、健康教育69.60%;③高血压社区控制管理指标期望控制水平：≥35岁首诊测压率93.16%、检出率55.84%、登记率96.33%、建档率794.43%、治疗率90.51%、知识知晓率89.42%、高血压知晓率89.49%、控制率85.85%、随访率93.57%、健康教育92.26%;④绩效考核指标赞同情况：测量血压（83.3%）、登记建档（87.5%）、健康教育（81.7%）、治疗（75.1%）、随访（82.1%）、转诊（58.4%）、周期性健康体检（76.3%）;⑤绩效考核指标的绩效分值情况：测血压22.34分、登记建档17.49分、健康教育14.68分、治疗16.01分、随访13.31分、转诊6.38分、周期性健康体检10.14分。结论：①几乎所有的调查对象均认为高血压应列入社区控制疾病,因此实行以高血压为首的社区卫生服务绩效考核制有广泛的民意基础。②目前各指标的实际控制水平和期望控制水平存在较大差异;③高血压社区防治管理绩效考核指标依次为：登记建档、测量血压、随访、健康教育、周期性健康体检、治疗和转诊;④绩效分值配比中最高为测量血压,最低为转诊。

Hypertension prevention and cure management index and itsperformance evaluation in communities

Objective To analyze and determine community management of hypertension,performance measurement index and assessment score matching,to discuss hypertension control and evaluation system of communities.Method A stratified cluster sampling was conducted in Jianggan district of Hangzhou city and in Yinzhou district of Ningbo city,which are community health service center with combination of urban and rural.The questionnaire about performance evaluation information of community hypertension prevention and cure was designed by ourselves.ResultsFirst,96.5% of the respondents thought that hypertension should be included in community disease control.Second,the actual control level for hypertension management indicators in the community was as follows: blood pressure measurement rate of patients over 35 in the first consultation was 76.02%,detection rate 39.09%,the registration rate 80.28%,construction document rate 76.28%,treatment rate of hypertension 69.56%,knowledge rate 62.70%,awareness rate of hypertension 70.28%,control rate 53.75%,follow-up rate 74.76%,and health education rate 69.60%.The actual control level failed to meet the expectation control level with significant difference.Third,the performance evaluation index proportion was the measurement of hypertension being 83.3%,registration files 87.5%,health education 81.7%,treatment 75.1%,follow-up 82.1%,referral 58.4% and periodic health examination 76.3%. Fourth,scores of performance evaluation indicators were measurement of blood pressure being 22.34,registered files 17.49,health education 14.68,treatment 16.01,follow-up 13.31,referral 6.38,and periodic health examination 10.14.Conclusions First,the performance evaluation system of community health service with hypertension as the first was widely endorsed.Second,there were lots of differences between the actual control levels and the expectation control levels for all indicators at present.Third,the hypertension prevention and management performance evaluation indicatiors in the community were registration files,measurement of blood pressure,follow-up,health education,periodic physical examination,treatment and referral.Fourth,the highest of achivevement scores was measuring blood pressure,while the lowest score was referral.