徐继英, 严青华, 姚海宏, 李新建, 王玉恒, 程旻娜, 施燕, 仲伟鉴. 上海市高血压患者社区管理现状分析[J]. 上海预防医学, 2016, 28(7): 442-447.
引用本文: 徐继英, 严青华, 姚海宏, 李新建, 王玉恒, 程旻娜, 施燕, 仲伟鉴. 上海市高血压患者社区管理现状分析[J]. 上海预防医学, 2016, 28(7): 442-447.
XU Ji-ying, YAN Qing-hua, YAO Hai-hong, LI Xin-jian, WANG Yu-heng, CHENG Min-na, SHI Yan, ZHONG Wei-jian. Analysis on management of patients with hypertension in communities in Shanghai[J]. Shanghai Journal of Preventive Medicine, 2016, 28(7): 442-447.
Citation: XU Ji-ying, YAN Qing-hua, YAO Hai-hong, LI Xin-jian, WANG Yu-heng, CHENG Min-na, SHI Yan, ZHONG Wei-jian. Analysis on management of patients with hypertension in communities in Shanghai[J]. Shanghai Journal of Preventive Medicine, 2016, 28(7): 442-447.

上海市高血压患者社区管理现状分析

Analysis on management of patients with hypertension in communities in Shanghai

  • 摘要: 目的 了解上海不同地区35岁及以上人群中高血压社区管理的情况。方法 利用2013年开展的上海市慢性病及其危险因素监测项目问卷调查及血压测量获得的数据,分析我市35岁及以上人群中高血压患者参加社区管理、血压治疗及控制情况。采用复杂加权计算调查对象不同特征项目参数的率及其95%置信区间(CI),率的比较采用Rao-Scott χ2检验。结果 10 510例高血压患者中,7 343例知晓自己患有高血压,其中3 815例参加了高血压社区管理,经复杂加权后,社区管理率为49.74%(95%CI:45.66%~53.83%)。不同年龄组患者差异有统计学意义(χ2=68.120,P=0.002),其中65岁及以上组最高,为55.49%(95%CI:51.58%~59.32%),35~44岁组最低,为41.20%(95%CI:30.73%~52.54%);女性为51.12%(95%CI:47.17%~55.05%),男性为48.46%(95%CI:43.34%~53.61%),不同性别患者差异没有统计学意义(χ2=5.194,P=0.216);城市患者为47.66%(95%CI:42.55%~52.82%),城乡结合部患者为52.92%(95%CI:43.41%~62.24%),农村患者为52.84%(95%CI:44.96%~60.58%),各地区患者差异没有统计学意义(χ2=19.281,P=0.432)。纳入社区管理的高血压患者定期随访率为21.97%(95%CI:18.61%~25.74%)。不同性别患者间的差异有统计学意义(χ2=65.048,P=0.000),女性为27.42%(95%CI:22.77%~32.61%),高于男性的16.61%(95%CI:13.02%~20.93%);不同年龄、不同地区患者间的差异均无统计学意义(χ2=2.017,P=0.834;χ2=21.244,P=0.111)。纳入社区管理的患者高血压治疗率为95.47%(95%CI:94.08%~96.54%),不同年龄患者间的差异有统计学意义(χ2=40.346,P=0.006),其中65岁及以上组最高,为96.90%(95%CI:95.39%~97.93%),35~44岁组最低,为89.31%(95%CI:77.94%~95.19%);不同性别、不同地区间患者的差异均无统计学意义(χ2=7.983,P=0.055;χ2=0.881,P=0.807)。纳入社区管理的患者高血压控制率为38.98%(95%CI:35.55%~42.51%),不同年龄、不同性别、不同地区患者间的差异均无统计学意义(χ2=23.188,P=0.103;χ2=1.050,P=0.468;χ2=0.529,P=0.938)。结论 应当进一步扩大社区高血压患者定期随访的覆盖面,并制定个性化的干预方案,以提高其血压控制率。

     

    Abstract: Objective To understand the status of community-based management of hypertensive patients aged thirty-five or above in Shanghai. Methods Data from Shanghai Chronic Disease and Risk Factors Surveillance carried out in 2013 were used to analyze the community-based management and treatment and control of blood pressure of hypertensive patients aged thirty-five or above in Shanghai. Sample was weighted according to complex sampling scheme and post-stratification to calculate the rates with 95% confidence intervals (CI) for the subgroups according to different characteristics. The Rao-Scott χ2 test was performed to test for the differences of the rates of the subgroups. Results There were 10 510 hypertension patients were included in the study among which 7 343 patients were aware of their diagnosis, and a total of 3 815 patients had been under management in communities. After being weighted the rate of management of hypertensive patients in communities was 49.74% (95%CI:45.66%-53.83%). There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ2=68.120, P=0.002), the rate of management among the patients aged sixty-five or above was 55.49%(95%CI:51.58%-59.32%), while among the patients aged thirty-five to forty-four was only 41.20% (95%CI:30.73%-52.54%). The rate of management among females was 51.12% (95%CI:47.17%-55.05%), while males was 48.46% (95%CI:43.34%-53.61%), with no statistical significance (χ2=5.194, P=0.216). The rates of management in urban areas, sub-urban areas and rural areas were 47.66% (95%CI:42.55%-52.82%), 52.92% (95%CI:43.41%-62.24%), 52.84% (95%CI:44.96%-60.58%), respectively, with no statistical significance (χ2=19.281, P=0.432). The follow-up rate in patients with hypertension under standardized management in communities was 21.97%(95%CI:18.61%-25.74%). There was a significant difference between different genders (χ2=65.048, P=0.000). The rate of females was 27.42% (95%CI:22.77%-32.61%), which was higher than the rate of males (16.61%,95%CI:13.02%-20.93%). There were no significant differences among different age groups (χ2=2.017, P=0.834) and regions (χ2=21.244, P=0.111). The treatment rate was 95.47% (95%CI:94.08%-96.54%). There was a significant difference among different age groups (χ2=40.346, P=0.006). The treatment rate among the patients aged sixty-five or above was 96.90% (95%CI:95.39%-97.93%), while among the patients aged thirty-five to forty-four was 89.31% (95%CI:77.94%-95.19%). There were no significant differences among gender (χ2=7.983, P=0.055) and regions (χ2=0.881, P=0.807). The control rate of hypertensive patients managed in communities was 38.98% (95%CI:35.55%-42.51%), There were no significant differences among different age groups (χ2=23.188,P=0.103), gender(χ2=1.050,P=0.468) and regions(χ2=0.529,P=0.938). Conclusion We should further expand the coverage of the standardized management of hypertension patients in the community, and make personalized intervention plan, so as to improve blood pressure control rates of hypertension patients in the community.

     

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