| Objective: This study was undertaken to know the prevalence status and main risk factors of hypertension about the community residents in Dong Hu district.According to the facilities,manpower,funds,resources of the comprehensive hypertension control and prevention agency,the hypertension related knowledge and skills status of community health service workers,analyzed the needs and problems of hypertension prevention and control in this area,then put forward policies and measures of hypertension prevention and control in Donghu district.Methods: Data were collected by stratified cluster sampling method and population capacity ratio method.Surveyed and measured the prevalence and risk factors of hypertension of 3263 community residents which aged 18 or above in Donghu District.The coping resources of community health service institutions of hypertension survey was used census method :including housing,equipment,funds,manpower and the basic situation of the prevention of hypertension.Meanwhile,a questionnaire survey was conducted to knew the hypertension related knowledge and skills of all community health service staff.Data was entered and settled by Epi Data software,statistical analyzed by SPSS17.0,statistical method included Chi-square test,Mann-Whitney tests,Logistic regression analysis and so on.Results:(1)Totally surveyed 3263 permanent community residents which aged 18 or above,men accounted for 47.5%,female 52.5%.The community residents hypertension prevalence in Donghu District was 21.85%,the adjusted prevalence rate of hypertension was 13.17%.The prevalence of hypertension in men and women were no difference(P>0.05).The unemployed or wait for employment persons,lower education level persons,older age persons,widows and widowers,Tengwang pavilion sub-district persons,free medical service of adult and medical insurance for urban workers were the highest prevalence of hypertension in Donghu district(all P<0.001).(2)Totally investigated 24 CHS institutions,about 79.17% institutions rent the business houses,16.67% for government provision,4.17% for purchase.The total annual income of this 24 institutions were 28,421,400 yuan,the allocation financial accounting for 17.06% in total income,accounting for 5.12% earmarks of total revenue.There are 390 staff,the health care ratio was 1.34:1.About 84.87% medical staff had qualification,educational level focus on training school diploma accounted for 68.46%,titles accounted for 47.96 % of primary,the constituted of professional as follows:clinical accounted for 35.13%,care accounted for 26.15%,preventive medicine and public health accounted for 13.08%.The kinds of drug between 24 CHS institutions had a big difference,essential drugs only accounted for 64.05%.From the 9 CHS centers,only six have 104 beds,the average number of open beds was 11.56,the average bed utilization rate was 48.16%.Hypertension treatment device of 9 CHS centers were better than 15 CHS stations.(3)From the 290 medical staff,about 93.1% have participated in the work of hypertension prevention and treatment,87.59% stuff have participated in the training of hypertension prevention and control,main details of training were prevention and risk factors,respectively accounted for 95.67% and 93.70%.The drug knowledge,knowledge of risk factors,prevention knowledge,knowledge of complications,follow-up management knowledge of medical staff in different CHS institutions were statistically significant(all P <0.05).30.34% medical staff satisfied with hypertension treatment work,63.79% medical staff considered ordinary,28.28% medical staff satisfied with hypertension prevention work,66.55% thought general.(4)Residents prevalence of hypertension was 21.85% in Donghu district,there should be 83,152 cases of patients with high blood pressure in this area.From the residents,alerted and diagnosed with hypertension rate was 16.45%,so there are 62602 people should be knew,patient awareness rate was 75.29%.In the hypertension patients,there are 33893 cases may not be known by community physicians,accounted for 54.14%,and the hypertension standardized management rate of community physicians knew was only 25.91%,the effectively control rate of community doctors knew was 69.11 %,the actual effective control rate was 6.18%.Conclusion:(1)It was found that the adult residents' prevalence rates of hypertension in Donghu district was significantly higher than that of 2011 in the area,and the hypertension prevalence rates was located in the first of chronic single disease.So,the hypertension should be put in the most important area of community comprehensive prevention and control of chronic diseases in Donghu district.(2)The high-risk groups intervention strategies in Donghu district were:pay attention to the older people,widowers and widows,lower education level people,unemployed people and free medical service people.(3)The high-risk behavior intervention strategies were:focus on the weight control,advocate a low salt diet,go to physical examination regularly,ensure sleeping time and strengthen the sport.(4)The main problem of hypertension prevention coping resources in this district: lack of fiscal expenditure,facilities and equipment conditions are relatively weak,the human resources allocation of community health service centers and stations was unreasonable,the national essential drugs were not coverage wholly,the medical staff on hypertension related knowledge and skills is not enough,the satisfaction of hypertension prevention and treatment work is not good.It recommends that the investment,equipment,talents,medicines,and the hypertension knowledge and skills of hypertension prevention should be adjusted and supplemented to meet the needs of the residents of hypertension prevention and control in Donghu District;(5)The results demonstrated that the community residents' prevalence of hypertension in Donghu district was high,residents' awareness and diagnosis rate was low,the community doctors' diagnosis,awareness,standardized management rate was lower,effective control of the actual rate was the lowest,the hypertension prevention and control situation in Donghu district was grim.It recommends that the health administrative departments should attach great importance to the comprehensive prevention and treatment of hypertension,frontier community health service institutions should learn from the successful experience around the world,combining prevention with control,improve the standardized management system of hypertension,regularly carry out the quality management evaluation,develop appropriate incentive mechanisms,effectively curb the harm of high blood pressure,and improve the health level of residents. |
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