论文部分内容阅读
目的了解湖南省基层医疗卫生机构慢性病管理能力现状。方法采用多阶段分层整群随机抽样方法,对湖南省长沙、株洲、郴州、怀化、岳阳市的390名基层医疗卫生机构医务人员进行慢性病保健评估问卷调查。结果湖南省社区医务人员慢性病保健评估问卷(ACIC)总分为(7.14±1.84)分,各维度得分由低到高依次为自我管理支持(5.29±1.63)分、决策支持(6.92±2.25)分、组成部分整合(7.31±2.09)分、卫生信息系统(7.35±1.99)分、社区联系(7.36±2.29)分、服务系统的设计(7.49±2.12)分、卫生保健系统(7.91±2.07)分。长沙市社区医务人员在ACIC总分、卫生保健系统的组织、社区联系、自我管理支持、服务系统的设计得分均高于郴州和怀化市(P<0.05);初级职称社区医务人员在决策支持、服务系统的设计得分高于中级职称和副高级以上职称,同时在总分、社区联系、卫生信息系统得分高于副高及以上职称,而中级职称在社区联系、决策支持、服务系统的设计、卫生信息系统得分均高于副高及以上职称(P<0.05);不同所属地(农村/城市)、性别、学历、工作年限、职位社区医务人员ACIC量表得分差异无统计学意义(P>0.05)。结论湖南省基层医疗卫生机构医务人员在进行慢性病管理时自我管理支持能力较低,同时慢性病管理服务能力也存在地区差异。
Objective To understand the status of chronic disease management in primary health care institutions in Hunan Province. Methods The multistage stratified cluster random sampling method was used to survey the health care of 390 primary health care workers in Changsha, Zhuzhou, Chenzhou, Huaihua and Yueyang in Hunan Province. Results The total score of chronic health assessment questionnaire (ACIC) of community health workers in Hunan Province was (7.14 ± 1.84) points. The scores of all dimensions were self-management support (5.29 ± 1.63) and decision support (6.92 ± 2.25) points from low to high , Component integration (7.31 ± 2.09), health information system (7.35 ± 1.99), community connection (7.36 ± 2.29), service system design (7.49 ± 2.12) and health care system (7.91 ± 2.07) . Changsha community health workers in the ACIC score, health care system organization, community relations, self-management support, service system design scores were higher than in Chenzhou and Huaihua City (P <0.05); junior professional community health workers in decision support, Service system design score higher than the intermediate grade and above the title, at the same time in the total score, community contact, health information system score higher than the title and above, and intermediate grade in community relations, decision support, service system design, (P <0.05). There was no significant difference in scores of ACIC among different positions (rural / urban), sex, educational background, working years and positions of community health workers (P> 0.05). Conclusions The medical staffs in primary health care institutions in Hunan Province have a lower self-management support ability in the management of chronic diseases, and there are also regional differences in the ability of chronic disease management services.