| 家庭医生制度下脑卒中高危人群筛查结果及成本分析 |
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| 引用本文： | 孙兰,万玉静,姚婷,张小燕.家庭医生制度下脑卒中高危人群筛查结果及成本分析[J].中华全科医学,2018,16(9):1504. |
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| 作者姓名： | 孙兰 万玉静 姚婷 张小燕 |
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| 作者单位： | 上海市闵行区新虹社区卫生服务中心, 上海 201107 |
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| 基金项目： | 上海市闵行区自然科学研究课题(2017MHZ24) |
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| 摘 要： | 目的 对上海市新虹社区开展家庭医生制度下脑卒中高危人群筛查,对筛查结果和筛查成本进行分析,为城市地区开展脑卒中社区防治提供政策依据。 方法 按每位家庭医生管辖区域,随机抽取所管辖建档高血压患者家庭100户,调查该家庭中35周岁及以上共2 760名居民。采用统一制定的《脑卒中高危人群信息登记表》面对面进行调查共2 693人。采用现场集中方式对高危人群筛查阳性居民进一步开展《脑卒中高危人群初筛评估表》问卷调查并检查血清同型半胱氨酸(Hcy)和颈动脉彩超检查,共完成筛查868人。 结果 问卷筛查出高危人群868人,检出率为32.23%。血Hcy检测结果:低Hcy 140人(16.13%)、中Hcy 424人(48.85%)以及高Hcy 304人(35.02%)。颈动脉超声检查有颈动脉斑块者为548人(63.13%),颈动脉狭窄者19人(2.19%)。平均问卷筛查1例成本为16.54元/例,确诊1例高危人群平均成本为51.32元/例;平均完成2个项目筛查成本为 93.54元。 结论 高血压家庭成员脑卒中危险因素暴露处于较高水平;慢性病患者家庭健康管理应是家庭医生工作重点,50岁以上男性居民是社区脑卒中防治中重点人群;应该加强筛查的成本管理,提高筛查收益。
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| 关 键 词： | 脑卒中 高危人群 筛查 成本 |
| 收稿时间： | 2017-11-18 |
Analysis of screening results and cost of high risk population of stroke by family doctors in urban areas |
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| Affiliation: | Xinhong Community Health Service Center, Shanghai 201107, China |
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| Abstract: | Objective To screen the high-risk population of stroke by family doctors in Shanghai Xinhong Community, to analyze the screening results and the cost, and to provide the policy basis for community prevention and control of stroke in urban areas. Methods According to the jurisdiction area of each family doctor, 100 families with hypertension were randomly selected, and 2 760 residents aged 35 years and above were investigated. Using the unified screening questionnaire to survey risk factors, 2 693 people completed the questionnaire, with 868 high risk population to further complete assessment questionnaire and exam on the serum homocysteine (Hcy) and the bilateral carotid ultrasonography in hospital. Results A total of 868 high-risk population people were screened by questionnaire, the detection rate was 32.23%. Serum Hcy test results:low Hcy 140 people (16.13%), middle Hcy 424 people (48.85%), and high Hcy 304 people (35.02%). The bilateral carotid ultrasonography results:fresh arterial plaque for 548 people (63.13%), carotid artery stenosis and 19 (2.19%).The average cost of screening 1 case was 16.54 yuan; the average cost of 1 high-risk groups was 51.32 yuan; the average cost of screening 2 items was 93.54 yuan. Conclusion The risk factors of stroke in hypertension family members were exposed to a higher level; Family health management of people with chronic diseases should be the focus by family doctors, especially on the male residents over the age of 50.The cost management should be strengthened to improve the profit of screening. |
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