通讯作者: 张小娟, zhangxjzhang@163.com

DOI：10.12201/bmr.202311.00002

Study on the Prevention and Treatment of Hypertension and Diabetes Mellitus in Community Hospital

• 摘要：目的：了解我国社区医院高血压和糖尿病患者健康管理和治疗的现状、发现问题并提出建议。方法：通过“优质服务基层行活动申报系统”收集3718家社区医院的相关信息。基于stata15.0开展描述性统计分析及多元线性回归分析。结果：社区医院各类卫生人员平均数均明显大于全国乡镇卫生院和社区卫生服务中心平均数；区域间存在差异，东部最多，中部最少，差异有统计学意义（P<0.001）。区域间设施设备和药品配备存在差异且有统计学意义（P<0.001），社区医院配备7-9种抗高血压和降血糖基本药物的机构占比最高。区域间高血压和糖尿病的诊疗人次及家庭医生续约率的差异有统计学意义（P<0.001），签约率的区域间差异无统计学意义（P=0.123和P=0.165）。高血压和糖尿病患者规范管理率西部最高，血压和血糖控制率中部最高，差异均有统计学意义（P<0.001）。多因素分析结果显示，社区医院注册全科医师数、药品配备、续约率、收入构成对高血压和糖尿病诊疗人次的影响有统计学意义（P<0.05），但这些因素大多对规范管理率和血压、血糖控制率的影响没有统计学意义。结论：东部地区社区医院人力资源和药品配备情况最优，但西部地区社区医院设施、设备配备等硬件条件最优。高血压和糖尿病医防融合仍待落地，规范管理率和血压、血糖控制率等公共卫生指标与机构医疗服务能力脱钩，医疗服务和公共卫生服务相关指标呈“倒置”状态，前者东部高，后者西部高，公共卫生数据质量和服务内涵有待提高。

  关键词： 高血压；糖尿病；社区医院；慢病防治；医防融合; ; ; ; 

   

  Abstract: Objective: To understand the current situation of health management and treatment of patients with hypertension and diabetes in community hospitals in China, find out the problems and put forward suggestions.Methods: The data of 3718 community hospitals was collected through the Quality Service Grass-roots Activities Declaration System.Descriptive statistical analysis and multiple linear regression analysis were carried out based on stata15.0.Results: The average level of all kinds of health personnel in community hospitals was significantly higher than the average level of township hospitals and community health service centers in China; there were differences among regions, the eastern region was the most, and the central region was the least, and the differences were statistically significant.There were statistically significant differences in the allocation of facilities, equipment and drugs among regions, and the proportion of community hospitals equipped with 7-9 kinds of essential anti-hypertensive and hypoglycemic drugs was the highest.There were significant differences in the number of patients with hypertension and diabetes and the renewal rate of family doctors among regions, but there was no significant difference in the signing rate among regions.The standardized management rate of patients with hypertension and diabetes was the highest in the west, and the control rate of blood pressure and blood sugar was the highest in the middle, and the differences were statistically significant.The results of multivariate analysis showed that the influence of human resources, drug allocation, renewal rate and proportion of medical insurance fund on the number of patients with hypertension and diabetes in community hospitals was statistically significant, but most of these factors had no statistical significance on the standardized management rate and the control rate of blood pressure and blood sugar.Conclusion: The human resources and drug allocation of community hospitals in the eastern region are the best, but the hardware conditions such as facilities and equipment allocation of community hospitals in the western region are the best.The integration of hypertension and diabetes still needs to be implemented, the standardized management rate and public health indicators such as blood pressure and blood sugar control rate are decoupled from the medical service capacity of institutions, and the related indicators of medical services and public health services are inverted, the former is higher in the east, the latter is higher in the west, and the quality of public health data and service connotation need to be improved.

  Key words: : hypertension; diabetes; community hospital; prevention and treatment of chronic diseases; integration of treatment and prevention

  提交时间：2023-11-17

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2023-07-24	bmr.202311.00002V1	下载

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