中国全科医学2018，Vol.21Issue(10)：1183-1187,1192,6.DOI:10.3969/j.issn.1007-9572.2018.10.008
高血压患者的治疗路径及分级诊疗开展现状研究
Development of Hierarchical Treatment for Hypertension in China: a Study Based on the Analysis of Hypertension Treatment Pathways
摘要
Abstract
Objective To explore the development of hierarchical treatment for hypertension in China via analyzing hypertension treatment pathways,proving a reference for domestic formulation of hierarchical treatment pathways for chronic diseases.Methods The data stemmed from the monitored results of healthcare utilization among residents,a pilot survey initiated by the Statistics Information Center,National Health and Family Planning Commission of the PRC between July and December 2016.We enrolled a sample of 1 536 hypertension patients with data for 6 consecutive months.We collected their sociodemographic characteristics,healthcare seeking status,treatment (both outpatient and inpatient treatment).XMind 7.5 was used to draw the treatment pathway map.The treatment in grassroots medical institutions and bi-directional referrals were analyzed in detail.Results Among the 1 536 participants,951 (61.9％) were from urban areas;1 470 (95.7％) received treatment [925 (62.9％) of them receiving treatment from medical institutions].Of the 164 patients receiving only once outpatient treatment,113 (68.9％) received it from the grassroots medical institutions.For 546 patients receiving multiple outpatient treatments from the same institution,372 (68.1％) of them received the treatment from the grassroots medical institutions.With regard to 182 patients receiving multiple outpatient treatments from different institutions,106 (58.2％) received the initial treatment from the grassroots medical institutions.The rate of receiving treatment from grassroots medical institutions among the patients varied significantly by region,annual household income per capita,prevalence of other diseases except hypertension (P＜0.05).182 patients received totaled 663 treatments from different medical institutions,including 142 (21.4％) treatments from the higherlevel institutions,373 (56.3％) treatments from different institutions of the same level,and 148 (22.3％) treatments from the lower-level institutions.Conclusion Most hypertension patients sought medical care,and they often visited grassroots medical institutions,but the referrals were not successful enough.In view of this,precise interventions should be given to hypertension patients first then to hypertension patients with other chronic diseases seeking medical care in grassroots medical institutions based on the conditions of the area they from and their own income;hypertension patients from urban areas should be incentivized to seek medical care in lower level medical institutions;redundant referrals between medical institutions of the same level and redundant unidirectional referrals should be controlled standardizedly.关键词
分级诊疗/高血压/治疗路径Key words
Hierarchical medical treatment/Hypertension/Treatment pathways分类
医药卫生引用本文复制引用
王丽萍,徐爱军..高血压患者的治疗路径及分级诊疗开展现状研究[J].中国全科医学,2018,21(10):1183-1187,1192,6.基金项目
江苏省社会科学基金项目(15GLB019) （15GLB019）
国家卫生计生委统计信息中心项目 （）
