广州市社区家庭医生服务干预在社区慢性病管理应用效果评价

doi:10.3969/j.issn.1006-3110.2017.04.025

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摘要目的调查广州市社区家庭医生式服务干预在慢性病管理的应用。方法选取2014年10月-2015年9月广州市某社区卫生服务中心门诊的88例慢性病患者,根据投硬币法分为观察组和对照组,44例每组,以提供家庭医生服务为干预。分析提供家庭医生服务前和提供家庭医生服务一年后两组患者的生化指标和生存质量变化情况,观察两组患者的血压、血糖控制率。结果干预后,观察组的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平显著低于对照组[(1.75±0.21)mmol/L比(2.19±0.18)mmol/L,(4.18±0.76)mmol/L比(5.06±0.98)mmol/L,(2.36±0.18)mmol/L比(3.87±0.39)mmol/L],高密度脂蛋白胆固醇(HDL-C)显著高于对照组[(1.87±0.46)mmol/L比(1.53±0.31)mmol/L],差异均有统计学意义(P<0.05)。观察组患者的血压、血糖控制率分别为90.91%、88.64%,显著高于对照组的70.45%、65.91%,差异有统计学意义(均P<0.05)。干预前,两组患者的生存质量评分比较差异无统计学意义(P>0.05),干预后,两组患者的生存质量评分显著高于干预前(P<0.05),观察组的社会关系领域、心理领域、生理领域及环境领域生存质量评分显著高于对照组(P<0.05)。结论通过家庭医生式服务能周全、更好的服务社区慢性病患者,使患者不良的生活习惯得到改善,提高临床疗效及患者的生存质量。

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	莫海韵
	陈少华
	罗志荣
	欧文森
	王金明
	王家骥

关键词 ：慢性病, 社区, 管理, 家庭医生

Abstract：Objective To investigate the application of community family doctor service intervention in chronic disease management in Guangzhou City. Methods Eighty-eight patients with chronic diseases were selected from the clinic of a community health service center in Guangzhou City from October, 2014 to September, 2015. All the patients were divided into the observation group and the control group (each n=44) according to the toss method, and the health intervention was conducted through family doctor services. We analyzed the biochemical indexes and the changes of quality of life before and after receiving one year of family doctor services in patients of the two groups, and observed the control rates of blood pressure and blood sugar in the two groups. Results After the intervention, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) of the observation group were all significantly lower than those of the control group ((1.75±0.21) mmol/L vs. (2.19±0.18) mmol/L, (4.18±0.76) mmol/L vs. (5.06±0.98) mmol/L, (2.36±0.18) mmol/L vs. (3.87±0.39) mmol/L), while the high-density lipoprotein cholesterol (HDL-C) of the observation group was significantly higher than that of the control group ((1.87±0.46) mmol/L vs. (1.53±0.31) mmol/L), with statistically significant differences (all P<0.05). The control rates of blood pressure and blood sugar were significantly higher in the observation group than in the control group (90.91% vs. 70.45%, 88.64% vs. 65.91%), showing statistically significant differences (both P<0.05). Before the intervention, no statistically significant difference was found in the quality of life score between the two groups (P>0.05). After the intervention, the quality of life scores of the two groups were both significantly higher than those of before the intervention (both P<0.05). The quality of life scores in the social relationship, psychological, physiological and environmental domains in the observation group were significantly higher than those in the control group (all P<0.05). Conclusions Implementing family doctor services can provide considerate and better health services for chronic disease patients in the community, improve the patients’ unhealthy living habits and increase the clinical curative effect and quality of life of patients.

Key words： chronic disease community management family doctor

收稿日期: 2016-11-11

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作者简介: 莫海韵(1990-),女,在读研究生,研究方向:流行病与卫生统计学。

引用本文:

莫海韵,陈少华,罗志荣,欧文森,王金明,王家骥. 广州市社区家庭医生服务干预在社区慢性病管理应用效果评价[J]. 实用预防医学, 2017, 24(4): 468-471. MO Hai-yun, CHEN Shao-hua, LUO Zhi-rong, OU Wen-sen, WANG Jin-ming, WANG Jia-ji. Evaluation on effect of community family doctor service interventionon community chronic disease management in Guangzhou. , 2017, 24(4): 468-471.

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