Objective To analyze the status of chronic disease management in community health service institutions in Haikou City, and to provide basis for formulating regional health planning and health policy.
Methods The health management rate, standardized management rate, blood pressure and blood glucose control rate of patients with chronic diseases were used as the evaluation indexes. A descriptive method was used to analyze the effect of the chronic disease management project in 44 community health service centers in Haikou City in 2018. A self-filling questionnaire was used to investigate the effect of the human resources and chronic disease prevention services in community health service institutions, and to explore the influencing factors.
Results The hypertension health management rate, standardized management rate and blood pressure control rate from 44 community health service centers in 2018 were 27.54%, 59.32% and 68.18%, respectively. In addition, the diabetic health management rate, standardized management rate and blood glucose control rate were respectively 20.28%, 62.95% and 66.59%. Except for the health management rate of diabetic patients, the other indexes were higher in the public community health service centres than those in the private community health service centres, and the difference was statistically significant ( P<0.05). There were 1 195 professional and technical personnel in 44 community health service centers, 20.92% of whom had bachelor’s degree or above, and 22.18% had intermediate and above professional titles. In terms of 36 services related to the management of chronic diseases, public community health service centers carried out a higher proportion than private community health service centers in the monitoring of key chronic diseases and the promotion of self-management of patients with chronic diseases, and the difference was statistically significant ( P<0.05).
Conclusion The poor quality of professional and technical personnel and the poor service quality of private community health service institutions are the important reasons for the low management level of chronic diseases in Haikou City. The government should strengthen the construction of grass-roots health personnel and strengthen the supervision of private community health service institutions.
摘要： 目的 分析海口市社区卫生服务机构慢性病管理现状, 为制定区域卫生规划和卫生政策提供依据。 方法 以慢性病患者健康管理率、规范管理率和血压、血糖控制率为评价指标, 应用描述性方法对海口市44家社区卫 生服务中心2018年基本公共卫生服务慢性病患者管理项目实施效果进行分析; 采用自填式问卷调查社区卫生服务机 构人力资源及慢性病防治服务开展情况, 探讨影响因素。 结果44家社区卫生服务中心2018年高血压病健康管理率、 规范管理率、血压控制率分别为27.54%、59.32%、68.18%; 糖尿病健康管理率、规范管理率、血糖控制率分别为20.28%、 62.95%、66.59%。除糖尿病患者健康管理率外, 其他各项指标比较公立社区卫生服务中心均高于民营社区卫生服务中 心, 差异有统计学意义( P<0.05)。44家社区卫生服务中心共有专业技术人员1 195人, 本科以上学历占20.92%, 中级以 上职称占22.18%。在与慢性病管理相关的36项服务提供上, 公立社区卫生服务中心在重点慢性病监测、推广慢性病 患者的自我管理等6项工作开展比例高于民营社区卫生服务中心, 差异有统计学意义( P<0.05)。 结论专业技术人员 素质不高以及民营社区卫生服务机构服务质量差是造成海口市慢性病管理水平低的重要原因, 政府应加强基层卫生 队伍建设并加大对民营社区卫生服务机构监管力度。