摘要
Abstract
Objective To discuss the effects of holding body on chronic disease management in community health service center(CHSC). Methods 48 CHSC in Haidian District of Beijing were selected as research object in June 2014. 18 CHSC were held by college ( CHSC held by college ), 23 by health administrative department directly ( CHSC held by government),and 7 by hospital(CHSC held by hospital). Data were collected from CHSC data in 2013 reported directly on network of management center of community health service in Haidian District, including community conditions of residents suffering from chronic,CHSC human resources condition,CHSC chronic disease management situations,and related indicators of CHSC chronic disease management stage. At the same time,directors and deputy directors in charge of medical care of five CHSC(1 CHSC held by college,3 CHSC held by government,1 CHSC held by hospital)were randomly selected to perform one-on - one interview. Results There was significant difference in the number of community hypertension patients, diabetic patients,community doctors per thousand population and registered nurses per thousand population among CHSC held by different holding bodies(P﹤0. 05);while the comparison of daily average outpatient number of community doctors per capita was not significantly different( P ﹥0. 05 ) . The annual average community clinic visits of hypertension patients and diabetes patients among CHSC held by different holding bodies(P﹤0. 05);the annual average community clinic visits of hypertension patients and diabetes patients in CHSC held by college were significantly higher than those in CHSC held by government and hospital( P﹤0. 05);Organized by different subject CHSC there was significant difference in physical examination rate,management rate of patients with hypertension and of patients with diabetes among CHSC held by different holding bodies(P﹤0. 05);there was no significant difference in management rate of the elderly aged over 65(P﹥0. 05). The physical examination rate,management rate of hypertension patients and of diabetes patients,and upward referral rate of CHSC held by college were significantly higher than those of CHSC held by government and hospital,the physical examination rate of CHSC held by government was significantly higher than that of CHSC held by hospital ( P ﹤0. 05 ) . Multiple linear regression analysis showed that holding bodies and management rate of hypertension patients significantly affected their annual average community clinic visits ( P﹤0. 05 );taking CHSC held by college as a reference,CHSC held by health administrative department significantly affected the annual average community clinic visits of diabetes patients ( P ﹤0. 05 ) . The affecting mechanism of holding bodies on community chronic disease management included the following aspects:traditional advantages that CHSC held by college was closely connected with the service of managed objects of chronic disease,service disadvantage of CHSC held by government caused by diversity of residents in the area and disadvantageous status of CHSC among competitive medical and health institutions. Conclusion In the three stages of chronic disease management,the management condition of CHSC held by college are superior to that of CHSC held by government and hospital;holding bodies and management rate of patients with chronic disease are the influencing factors.关键词
社区卫生服务中心/慢性病管理/举办主体Key words
Community health service center/Chronic diseases management/Holding bodies分类
医药卫生
