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目的:观察老年高血压、糖尿病患者医院-社区一体化管理模式应用效果。方法:在确诊并建立健康档案管理的老年高血压及糖尿病患者中随机选取100例高血压、100例糖尿病愿意采用医院-社区一体化管理模式管理的患者为一体化管理组,不愿意进行医院-社区一体化管理模式管理的100例高血压、100例糖尿病患者为常规管理组,分别进行常规管理模式管理、医院-社区一体化管理模式管理,比较干预前、干预后1年时血压、血糖控制达标情况及相关并发症的发生率。结果:两组患者干预前高血压、糖尿病达标率比较,差异无统计学意义(P>0.05),干预后较干预前明显提高,一体化管理组较常规管理组干预后达标率更高,组间比较,差异具有统计学意义(P<0.05)。结论:医院-社区一体化管理模式管理老年高血压、糖尿病患者有助于提高患者治疗达标率,效果显著。
Objective: To observe the effect of hospital-community integrated management of elderly patients with hypertension and diabetes mellitus. Methods: One hundred patients with hypertension and diabetes mellitus were randomly selected from elderly patients with hypertension and diabetes diagnosed with health records management. One hundred patients with diabetes mellitus who were willing to adopt hospital-community integrated management mode were all included in the management team. 100 cases of hypertension and 100 cases of diabetes mellitus managed by community-based management mode were regular management groups, which were respectively managed by conventional management mode and hospital-community integrated management mode. Before one year after intervention, blood pressure and blood glucose control Meet the situation and the incidence of related complications. Results: There was no significant difference between the two groups before and after the intervention (P> 0.05), and the difference between the two groups was significantly higher than that before the intervention (P> 0.05). The integration rate of the integrated management group was higher than that of the conventional management group Between the two groups, the difference was statistically significant (P <0.05). Conclusion: The hospital-community integrated management model to manage elderly patients with hypertension and diabetes helps to improve the patient’s compliance rate.