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| Community management of screening and intervention of high-risk population of stroke under the guidance of medical partnerships system and its effectiveness evaluation |
| ZHANG Pengchuan SONG Wei WANG Haiying HE Shaoqi ZHAO Ya′nan XIE Xiujuan |
| Department of Neurosurgery, Daxing Hospital of Traditional Chinese and Western Medicine, Beijing 100076, China |
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Abstract Objective To study the community management of screening and intervention of high-risk population of stroke under the guidance of medical partnerships and evaluate its effectiveness. Methods From January to December 2015, Demao Community and Hongxing Building Community in Daxing District of Beijing were selected as study bases. 200 cases with high-risk of stroke aged 41-91 were collected, and randomly divided into the intervention group (100 patients) and the control group (100 patients). 11 doctors from the two communities had been trained for standard of high-risk population of stroke screening and intervention pilot project in a tertiary general hospital that under the medical partnerships system. Patients in the intervention group were given follow-up management, patients in the control group were given no intervention. The main follow-up indicators for community doctors included awareness rate of screening and intervention in high-risk population of stroke, positive rate of screening, acceptance degree of standardized treatment; for patients included awareness rate of risk factors of stroke, medication rate, use rate of standardized drugs, self-daily life management rate. Results After standard training of high-risk population of stroke screening and pilot intervention, the awareness rate of community doctors on screening and intervention in high-risk population, the screening positive rate and the acceptance degree of standardized treatment were raised than before(P < 0.05). In the intervention group 96 cases had effective follow-up, and in the control group 97 cases had effective follow-up, the follow-up time was (18.5±0.5) months. The awareness rate of stroke risk factors, medication rate, rate of accepting standardized drugs and self-daily life management rate in the intervention group were higher than those in the control group (P < 0.05). Conclusion The community management model of screening and intervention in high risk population of stroke under the guidance of a tertiary general hospital that enrolled in medical partnerships system, improves the diagnosis and treatment levels of community doctors which in turn can be beneficial to recognizing and well-management of high-risk population, as well as the awareness rate and execution degree of management control program of community disease. It also improves the awareness rate and self-management level of patients with high risk factors, which contribute to patients′ medication rate and medical compliance, thus provides a new method for medical and health reform.
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