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2019—2022年青岛市城阳区“三高共管 六病同防”慢病管理模式对老年患者健康行为变化趋势及影响因素分析

Trends and influencing factors of health-related behaviors of elderly "three highs" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases" in a district of Qingdao city: an analysis of 2019–2022 surveillance data

  • 摘要:
    目的  探讨“三高共管 六病同防”慢病管理模式下老年患者健康行为的影响因素,为改进慢病管理模式提供参考依据。
    方法  利用2019—2022年青岛市城阳区乡镇卫生院/社区卫生服务中心“三高”管理信息系统数据,纳入连续4年进行监测且数据完整的43 150例≥60岁患者,选取吸烟、饮酒和体育锻炼3个指标来衡量患者健康行为,采用广义估计方程对患者健康行为进行影响因素分析。
    结果  2019—2022年青岛市城阳区≥60岁“三高”患者吸烟率呈先上升后下降趋势,2019年为13.09%,2020年略微上升到13.39%,2022年下降到12.25%。饮酒率呈先上升后下降趋势,2019年为16.44%,2020年略微上升到16.93%,2022年下降到15.07%。体育锻炼率呈现逐渐上升的趋势,从2019年的35.47%上升到2022年的42.39%。广义估计方程分析结果显示,男性患者吸烟率更高;男性、文化程度为小学和初中的患者更饮酒率更高;非本地户籍、文化程度较高、职业类型为非务农以及患“三高”种类较多的患者体育锻炼率更低。
    结论 山东省青岛市城阳区开展“三高共管 六病同防”慢病管理模式后,患者健康行为总体上呈好转趋势,但吸烟率和饮酒率仍处于较高水平,体育锻炼也有待进一步加强。

     

    Abstract:
    Objective To analyze the prevalence and influencing factors of health-related behaviors of elderly hypertension/hyperglycemia/hyperlipidemia (abbreviated as "three highs)" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases", and to provide a reference for improving the chronic disease management model.
    Methods Data of 43 150 elderly (≥ 60 years) "three highs" patients with consecutive follow-up information on health-related behaviors (smoking, alcohol consumption and physical activity) from 2019 to 2022 were collected from the Chronic Disease Management Information System of Chengyang District of Qingdao City. Generalized estimating equations were used to analyze the factors influencing patients' health-related behaviors.
    Results For all participants over the period, the prevalence of smoking and alcohol consumption showed the same trend of slightly increasing and then decreasing (smoking/alcohol consumption: from 13.09%/16.44% in 2019 to 13.39%/16.93% in 2020, 12.25%/15.07% in 2022); the prevalence of physical activity increased gradually from 35.47% in 2019 to 42.39% in 2022. The generalized estimating equation analysis showed that the male participants were more likely to have a higher rate of smoking, the participants who were male and those with primary or junior high school education were more likely to have a higher rate of alcohol consumption, and the participants with non-local household registration, with occupations other than agricultural worker, and with comorbidity of hypertension/ hyperglycemia/hyperlipidemia were more likely to have a lower rate of physical activity.
    Conclusions The implementation of the "Integrated Control and Prevention of Three Highs and Six Diseases" chronic disease management strategy in Shandong province generally improved health-related behaviors among elderly residents with hypertension/hyperglycemia/hyperlipidemia in a district of Qingdao city.

     

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