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目的了解上海市闵行区卫生局2004年起通过实行按项目拨款后对闵行区一级医院35岁以上首诊测压产生的影响。方法每年以拦截法随机抽查部分病人进行首诊测压工作质控,并对2003-2007年全区一级医院35岁以上首诊测压工作质控情况进行分析。结果2003-2007年全区共质控抽查了一级医院35岁以上首诊病人1150人,其中测压1005人,测压率87.39%;登记637人,登记率68.49%;规范数432人,规范率46.45%;复诊数482人,复诊测压数373人,复诊测压率77.39%;首诊测压工作中测压率、登记率、规范率纳入卫生局项目经费指标并在落实后有了大幅度的提高,2003-2005年测压率比较,差异有统计学意义(χ2=34.04,P<0.01);2006-2007年规范测压率比较,差异也有统计学意义(χ2=21.94,P<0.01);而复诊测压工作质量变化不大,甚至有下降趋势。结论35岁以上首诊测压工作是提高血压知晓率,早诊断、早治疗高血压患者的重要途径,上海市闵行区卫生局利用首诊测压年度工作质量下拨项目经费较大地促进和规范了该区一级医院首诊测压工作的开展,应继续扩大经费指标范围,将复诊测压纳入考核指标。
Objective To understand the influence of Shanghai Municipality Minhang District Health Bureau on the pressure measurement of the first clinic above 35 years old in Minhang District First Hospital since 2004 by appropriation according to the project. Methods A random sample of patients was intercepted to carry out quality control of pressure measurement in the first visit every year. The quality control of pressure measurement at the first grade hospitals over the age of 35 in 2003-2007 was analyzed. Results From 2003 to 2007, a total of 1150 first-time patients over 35 years of age were enrolled in the first grade hospital in Chongqing. Among them, 1005 were pressure-measuring, with a pressure measurement rate of 87.39%; 637 were registered with a registration rate of 68.49%; 432 were norms, The standard rate of 46.45%; the number of referrals 482, referral pressure measurement number of 373 people, the referral rate of pressure measurement 77.39%; the first survey of manometry manometry, registration rate, standard rate into the Health Bureau project funding targets and after the implementation of (Χ2 = 34.04, P <0.01). There was also a significant difference in standard manometry between 2006 and 2007 (χ2 = 21.94, P < P <0.01). However, the quality of referral manometry changed little or even decreased. Conclusions The first consultation of 35 years old is the important way to improve the awareness rate of blood pressure, early diagnosis and early treatment of hypertension. The Minhang District Health Bureau of Shanghai Municipality greatly promoted and standardized the use of the first annual survey of piezometric work quality The first hospital in the district to carry out the first survey of pressure measurement work, should continue to expand the scope of financial indicators, the referral pressure measurement included in the assessment indicators.