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目的分析北京市朝阳区基层医疗卫生机构慢性病防控能力现状以及工作中存在的制约因素和需求,为更好地开展慢性病预防控制工作提供依据。方法由经过培训的调查员对朝阳区42家社区卫生服务中心进行问卷调查以及现场定性访谈。结果 2011年各社区卫生服务中心(简称中心)从事公共卫生服务人员平均为15.7人,占平均在岗技术人员的16.7%。各中心基本公共卫生服务经费占各中心总体财政拨款的12.9%。各中心配备仪器情况良好,97.6%的中心存有现行的国家级慢性病防控规范或指南。100.0%的中心举办过慢性病防控相关的知识讲座,平均举办17.4次。35岁以上居民首诊测血压服务、45岁以上居民免费血糖检测服务和65岁以上老年人免费健康体检服务开展率分别为97.6%、33.3%和88.1%。100.0%的社区卫生服务中心开展了高血压和糖尿病患者的建档和随访管理工作。结论朝阳区基层慢性病防控机构不健全,而且资源不足,特别在人员方面。此外,朝阳区基层的慢性病防控缺乏自主性,对于高危人群的管理不够重视。
Objective To analyze the status of chronic disease prevention and control in primary health care institutions in Chaoyang District of Beijing and the constraints and needs in the work so as to provide evidence for better prevention and control of chronic diseases. Methods The trained investigators conducted a questionnaire survey and field interviews with 42 community health service centers in Chaoyang District. Results In 2011, the average number of public health service personnel in each community health service center (referred to as the center) was 15.7, accounting for 16.7% of the average on-the-job technical staff. Funds for basic public health services in each center account for 12.9% of the total financial allocations of the centers. The centers are equipped with instruments in good condition. 97.6% of the centers have existing national guidelines or guidelines on prevention and control of chronic diseases. 100.0% of the centers held lectures on chronic disease prevention and control, with an average of 17.4 times. Residents over the age of 35 were the first to have their blood pressure services tested. The rates of free blood glucose testing services for residents over the age of 45 and free health examination services for the elderly over 65 were 97.6%, 33.3% and 88.1% respectively. 100.0% of community health centers carry out documentation and follow-up management of patients with hypertension and diabetes. Conclusion The prevention and control mechanism of grassroots chronic diseases in Chaoyang District is not perfect, and the resources are not sufficient, especially in terms of personnel. In addition, the prevention and control of chronic diseases at the grassroots level in Chaoyang District lacks autonomy and lays little emphasis on the management of high-risk groups.