社区不同高血压管理模式对患者血压控制的影响

目的:研究不同高血压管理模式对高血压患者血压控制效果的影响。方法:选取新疆某县城区采取不同高血压管理模式的三家社区卫生服务中心,其中A机构开展基本公共卫生服务,不提供医疗服务;B机构提供基本公共卫生服务和医疗服务,并建立高血压责任医生制度;C机构基于区域医联体开展基本公共卫生服务和医疗服务。本研究于2013年7月和2015年12月调查三家社区卫生服务中心高血压患者的血压控制情况,运用Logistic回归对高血压管理效果进行分析。结果:A机构患者平均收缩压上升0.89mmHg(P0.05),平均舒张压上升0.67mmHg(P0.05),血压控制率下降2.54%(P0.05);B机构患者平均收缩压上升5.31mmHg(P0.01),平均舒张压下降1.70mmHg(P0.05),血压控制率提高2.70%(P0.05);C机构患者平均收缩压下降1.54mmHg(P0.05),平均舒张压下降2.97mmHg(P0.01),血压控制率提高16.24%(P0.05)。根据随机效应模型结果,从基线调查到结局调查,A机构患者血压控制的概率为C机构的0.27倍(P0.05),B机构患者血压控制的概率为C机构的0.41倍(P0.05)。结论:基于区域医联体的高血压管理模式可有效控制患者血压。

Effects of different modes of hypertension management on blood pressure control in patients with hypertension

Objective:To study the effect of different hypertension management modes on the blood pressure control in patients with hypertension. Methods:Three community health service centers in Xinjiang city were included in the study, which used different modes of hypertension management. Center A carried out the basic public health services, but did not provide medical services; Center B provided both the basic public health services and medical services, Center B also established the responsible doctor system; Center C carried out basic public health services and provided medical services based on the regional medical association. The blood pressure of patients with hypertension from the three centers were investigated in July 2013 and in December 2015. Using Logistic regression to analyze the effect of different management modes on blood pressure control. Results:The average SBP of patients from Center A increased by 0.89mmHg (P>0.05), the average BP increased by 0.67mmHg (P>0.05), the blood pressure control rate decreased by 2.54% (P>0.05); The average SBP of patients from Center B increased by 5.31mmHg (P<0.01), the average BP decreased by 1.70mmHg (P>0.05), the blood pressure control rate increased by 2.70% (P>0.05); The average SBP of patients from Center C decreased by 1.54mmHg (P>0.05), the average BP decreased by 2.97mmHg (P<0.01), the blood pressure control rate increased by 16.24% (P<0.05).According to the results of the random effect model, the likelihood of blood control of Center A is 0.27 times that of Center C (P<0.05), the likelihood of blood control of Center B is 0.41 times that of Center C (P>0.05). Conclusion:the hypertension management mode based on regional medical association can effectively control the blood pressure of patients with hypertension.