《中国高血压防治指南》在北京基层医师中实施的运行机制分析.pdfVIP

心肺血管病杂志2007年11月第26卷第4期 Journal ofCardiovascular＆Pulmonary Diseases，November 2007，Vo1．26，N0．4 205 · 临床论著· 《中国高血压防治指南》在北京基层 医师中实施的运行机制分析 任京媛 姚崇华 刘姝倩 [摘要] 目的：分析北京基层医师贯彻《中国高血压防治指南》(指南)的运行机制障碍，提出解决问 题的建议和具体措施。方法：系统随机抽样调查指南在400名北京市城乡基层临床医师中的执行情况。 结果：基层医师培训率为29．O％；向患者进行非药物治疗解释工作的医师比例为80．8％，城乡间差异有 显著性 (P0．001)；城乡继续教育的渠道不一，差异有显著性(P0．001)；62．8％的基层医师反映基层 药物种类少；19．8％的基层医师接收过上级医院转诊的患者。结论：1．应改进对基层医师的培训方法和 内容。2．基层医师非药物治疗指导方式有待提高。3．从教育形式和内容方面加强农村基层医师的继 续教育。4．完善贯彻指南的激励机制。5．医疗保险体制改革应重视社区卫生服务站的降压药物种类 使用的政策。6．进一步完善双向转诊制度以提高高血压患者管理的费效比。 (关键词] 高血压；指南；贯彻 Survey on implementing“The Guidelines for Prevention and Treatment of Hypertension in China”in GPs in Beijing REN~ngyuan，YAO c ， 龇，LIU Shuqian Department of Community Health，Beijing Institute of Heart， ， and Blood VesselDisease，Beijing 100029，China 【Abstract] Objective：To analyze Barriers of the implementation of“The Guidelines for Prevention and Treatment of Hypertension in China”in GPs in Beijing and suggest on further spreading and improving the adherence of the guideline．Method：A cross-sectional study with questionnaire interview was conducted in Beijing primary csEe settings．40O GPs were selected by systematic random sampling．Result~1．Th e proportion of being trained of the guideline was 29．0％ in GPs．2．80．8％ of the GPs got advice on lifestyle instruction to hypertensive patients．but there was significant difference in the proportion between urban areas and rural areas(P0．001)．3．The approaches of professional training for GPs were different between urban alias and rural areas．There was significant difference in the proportion between urban areas and rural areas(P0．001)．4．62．8％ of the GPs thought lock of drugs affect．5．92．7％ ofthe GPs could ensure timely，but less ofthem back(19．8％)．Conclusion：1．The training pattern and contents should be improved．2．The skill of instruction in GPs of lifestyles should b