摘要目的 探讨社区规范化管理对高血压的防治效果及其经济学意义.方法 2010年10月至2011年9月,我们采用前瞻性对照设计,在常平镇按随机数字表法随机抽取4个社区(土塘、桥梓、桥沥、田尾)进行筛查,确诊高血压患者439例.随社区分为干预组(2个社区,221例)、对照组(2个社区,218例).干预组根据“中国高血压防治指南(2009年基层版)”采取规范化管理,对照组采取常规管理.结果 ①1年后,共412例进入分析,包括干预组216例、对照组196例.干预组管理后治疗率为89.35％、控制率为65.74％,分别高于管理前的38.01％、13.12,干预前后比较差异均有统计学意义(x2=124.11、126.99,P均＜0.001).对照组管理后治疗率为65.31％、控制率为40.31％,高于管理前的37.62％、13.76％,管理前后比较,差异均有统计学意义(x2=31.71、37.51,P均＜0.001).②干预组每提高1％的治疗率,所需人均管理成本比对照组少投入1.09元；干预组每提高1％的控制率所需人均管理成本比对照组少投入1.37元.干预组管理后治疗率、控制率均高于对照组(x2=34.53、26.74,P均＜0.001).③干预组人均管理成本为176.43元,高于对照组(125.33元)；干预组人均综合费用为1403.98元,低于对照组(1791.32元).干预组人均管理成本每增加1元,可减少各项综合费用7.58元(个人费用3.98元、社保负担费用3.60元).结论 社区规范化管理可提高高血压病的防治效果,具有较好的成本-效果比,可节省社会资源.

abstractsObjective To discuss the effectiveness of standardized management of hypertension and its significance of economics.Methods Taking prospective,randomized and controlled trial design to screen hypertension in four communities of Changping Town.The patients in the four communities were randomly divided into an intervention group and a control group.The intervention group was taken the standardized management and the control group was taken conventional management.Results The treatment rate and control rate of the intervention group was higher than the control group.Necessary inputs of per capita administration costs for every 1％ increase of treatment or control rate in the intervention group were less than the control groups by 1.08 and 1.36 Yuan respectively.The per capita administrative costs of intervention group were higher than control group,while the per capita comprehensive costs of intervention group were lower than control group.Compared with the control group,every 1 Yuan of per capita administrative costs increases,the comprehensive costs would be reduced 7.58 Yuan in the intervention group.Conclusion Standardized management of hypertension in community can significantly improve the prevention and treatment effects.Moreover,it has good cost-effective value and saving social resources.