| Background and ObjectivesHypertension was the highest incidence of cardiovascular disease in chronic non-communicable diseases, important cause and risk factors of Stroke, coronary heart disease, kidney disease, which was becoming the world’s most important public health problem. Data shows that there were one billion hypertensive patients in the world, accounting for death in the first place. In China, there were about160million patients with hypertension and an increase rate of about3million annually, has become the most serious in the world. Yu hang District, the number of hypertension management in2008were25,682cases, reached72,639people in2012, the average annual growth rate was23.11%; the hypertension prevalence in2008was3.07%, in2012was8.13%, has increased5.06percentage points, and the situation is very grim.With the attention of the high blood pressure at home and abroad, the high blood pressure was from without treatment era to drug therapy era, leap to the comprehensive lifestyle intervention time by now, Community management has become a consensus of experts at home and abroad, and follow-up mode is one of the most important aspects of the community management of high blood pressure. And the follow-up mode can directly affect the patients with high blood pressure blood pressure control is good or bad. Yu hang District, based on hierarchical management of hypertension, has created many new follow-up management responsibilities, such as full-time community physicians come up mode, telephone follow-up mode, the club up mode, etc. In order to understand the different follow-up patterns in patients with hypertension awareness, behavior change rates, and changes in the health indicators of the impact, evaluate the effectiveness of different follow-up patterns and influencing factors, to further standardize the management of hypertension community, explore actual follow-up management of Yu hang District model and provide a theoretical basis.Materials and MethodsAdopt the method of cluster random sampling in stages. Firstly, the participating East Lake Street, Huang Town hypertension club members for the survey, and secondly, the home full-time doctors Baizhang Town Patients were followed up for the survey, finally, other towns, the villages were randomly drawn a street or community, and then sampled100people in the villages or communities randomly, less than100people in the village or community as to investigate all patients with hypertension. Questionnaire used by trained professionals face to face survey manner. Use the excel2003and spss19.0for statistical analysis.ResultsDifferent follow-up mode has nothing to do with the patient’s gender, whether the treatment of hypertension, with other factors were statistically significant. The average age of2187hypertensive patients was65.23±10.19, the comparisons showed that doctors come-up mode and patients to the clinic, the two follow-up patterns have differences on age composition,65years or older are more likely to follow the doctors come-up mode; Patients with primary school education and above have nothing to do with follow-up mode, but illiteracy education of the patients had statistically significant, the least inclined to telephone follow-up. Cadres occupations patients were followed up mode selection is more tendentious, in general, prefer collective type of follow-up model, not like a single type of follow-up model, in particular, do not tend to follow the doctors come-up mode; Agriculture, forestry, animal husbandry, fishery and water conservancy occupations patients tend club form. In the collective-style mode, doctors go home+periodic follow-up model of collective knowledge among were the highest, phone and phone+patients to the clinic follow-up mode knowledge among were the lowest. The group of doctors go home+Patients to the clinic was one of the highest rates of blood pressure control up (the rate was65.48%), the compliance was also the highest (was88.24%), the followed was the patient to the clinic+periodic centralized model, compliance was76.79%, and doctors go home+periodic centralized model has the least minimum compliance and also with other models has statistically significant. Blood pressure control rate of separate follow-up model was higher than of the collective follow-up mode, and control rate of patients with follow-up includes doctors come-up mode was higher than without medical follow-up of patients. Analysis of the main follow-up mode, the results show that the behavior change rate of telephone follow-up rate was the highest, reaching67.15percent, the results obtained behavior change rate of separate style pattern is higher than of the collective style. Psychology degree was affected by the follow-up mode of doctors go home+Patients to the clinic was the smallest, and separate type of follow-up mode was affected by less than collective-style follow-up.Based on Logistic regression analysis, the patient’s occupation, BMI, treatment, familiar with their own community responsibility physicians, regular pressure cycle, self scores, single type of follow-up mode such as the protective factors for blood pressure control. The culture and education degree, occupation, aware of knowledge about hypertension, pattern of work at ordinary times, medication compliance, self health score, blood pressure control or not can affect the choice of follow-up mode. ConclusionsThe current follow-up mode of hypertension community in Yu hang District were suitable for practical, the compliance, knowledge awareness, blood pressure control rate, treatment rate were relatively high. Overall the separate type of follow-up model was better than the collective style up mode, but in the health knowledge of publicity, collective style was more dominant. Because each follow-up mode has its own advantages and disadvantages, we can combine with the actual of health resources and the patient’s personality traits, and accord to the different stages of management to choose more efficient and economical follow-up mode. |
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