摘要
目的 探讨血脂异常合并高血压患者健康管理的效果及成本效果.方法 选取2020年2月至2022年2月期间我院134例血脂异常合并高血压患者作为研究对象,根据社区管理模式将2020年2月至2021年2月期间行常规管理模式干预58例患者纳入对照组,2021年3月至2022年3月期间行健康管理模式干预76例患者纳入观察组.比较两组患者管理干预前后血压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较,并统计观察组开展血脂异常合并高血压健康管理项目投入的成本,并根据干预前后改善情况进行管理成本效果分析.结果 观察组收缩压、舒张压、TC、TG、LDL-C、HDL-C干预前后差值高于对照组,差异具统计学意义(P＜0.05).人均管理成本和收缩压成本效果比为32.3∶1,收缩压水平每下降1mmHg,此时舒张压下降0.69mmHg,人均投入管理成本32.3元;人均管理成本和舒张压成本效果比为47.2∶1,舒张压水平每下降1mmHg,此时收缩压下降1.46mmHg,人均投入健康管理成本47.2元.观察组患者TC、TG、LDL-C分别降低0.86mmol/L、0.67mmol/L、0.74mmol/L,HDL-C 升高 0.08mmol/L,人均管理成本和 TC、TG、LDL-C、HDL-C 成本效果比分别为286.4∶1、367.6∶1、332.8∶1、3078.4∶1.TC水平每下降1mmol/L,人均投入管理成本286.4元;TG水平每下降1 mmol/L,人均投入管理成本367.6元;LDL-C水平每下降1 mmol/L,人均投入管理成本332.8元;HDL-C水平每上升1mmol/L,人均投入管理成本3078.4元.结论 健康管理模式对血脂异常合并高血压患者具有较好的效果,此外高血压管理项目较血脂异常管理项目具有更好的成本效果比.
Abstract
Objective To investigate the effect and cost-effectiveness of health management in patients with dyslipi-demia and hypertension.Methods One hundred and thirty-four patients with dyslipidemia complicated with hypertension in our hospital from Feb.2020 to Feb.2022 were selected.According to the community management mode,58 patients who underwent conventional management mode intervention from Feb.2020 to Feb.2021 were included in the control group,and 76 patients who underwent health management mode intervention from Mar.2021 to Mar.2022 were included in the observa-tion group.The levels of blood pressure,total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)before and after management intervention were compared between the two groups,and the cost of carrying out dyslipidemia and hypertension health management program in the observation group was counted,and the management cost-effectiveness analysis was performed according to the improvement before and after intervention.Results The differences of systolic blood pressure,diastolic blood pressure,TC,TG,LDL-C and HDL-C be-fore and after intervention in the observation group were higher than those in the control group(P＜0.05).The ratio of per capita management cost and systolic blood pressure cost-effectiveness was 32.3∶1,for every 1 mmHg decrease in systolic blood pressure level,diastolic blood pressure decreased by 0.69 mmHg,and per capita investment management cost was 32.3 yuan;the ratio of per capita management cost and diastolic blood pressure cost-effectiveness was 47.2∶1,for every 1 mmHg decrease in diastolic blood pressure level,systolic blood pressure decreased by 1.46 mmHg,and per capita invest-ment health management cost was 47.2 yuan.In the observation group,TC,TG and LDL-C decreased by 0.86 mmol/L,0.67 mmol/L and 0.74 mmol/L,respectively,HDL-C increased by 0.08 mmol/L,and the ratio of per capita management cost and cost-effectiveness of TC,TG,LDL-C and HDL-C was 286.4∶1,367.6∶1,332.8∶1 and 3078.4∶1,respectively.For every 1 mmol/L decrease in TC level,the per capita investment management cost was 286.4 yuan;for every 1 mmol/L de-crease in TG level,the per capita investment management cost was 367.6 yuan;for every 1 mmol/L decrease in LDL-C lev-el,the per capita investment management cost was 332.8 yuan;and for every 1 mmol/L increase in HDL-C level,the per ca-pita investment management cost was 3078.4 yuan.Conclusion Health management mode has a better effect on patients with dyslipidemia and hypertension,and hypertension management program has a better cost-effectiveness ratio than dyslipi-demia management program.
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20210090)
维普
万方数据