摘要： 背景 基本公共衛(wèi)生服務(wù)項(xiàng)目中的老年健康體檢服務(wù)對(duì)老年健康異常狀況檢出的貢獻(xiàn)及老年人對(duì)體檢結(jié)果的獲悉情況相關(guān)研究報(bào)道較少。 目的 了解≥65歲老年人健康體檢中發(fā)現(xiàn)的血壓異常、血糖異常、超重肥胖、貧血、脂肪肝、膽結(jié)石或膽囊炎幾種常見(jiàn)病的異常檢出情況。 方法 2019年11—12月，采用多階段分層抽樣法從我國(guó)東、中、西部的3省5市20所基層醫(yī)療衛(wèi)生機(jī)構(gòu)選擇前來(lái)就診的≥65歲老年人作為調(diào)查對(duì)象（排除本年度體檢結(jié)果不詳者），根據(jù)基本公共衛(wèi)生服務(wù)對(duì)象人群劃分標(biāo)準(zhǔn)，將研究對(duì)象分為一般老年人（不患有高血壓或糖尿病）、高血壓老年人、糖尿病老年人3類，對(duì)所有調(diào)查對(duì)象進(jìn)行"一對(duì)一"問(wèn)卷調(diào)查（問(wèn)卷內(nèi)容包括被調(diào)查者一般人口學(xué)特征、老年人健康體檢異常檢出情況）。 結(jié)果 3 018例老年人中，2 033例（67.36%）自報(bào)健康體檢異常。不同居住地類型、人群類型、所在地區(qū)、戶口類型老年人自報(bào)健康體檢異常率比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。3 018例老年人中，1 174例（38.90%）自報(bào)檢出血壓異常，747例（24.75%）自報(bào)檢出血糖異常，719例（23.82%）自報(bào)檢出血脂異常，445例（14.74%）自報(bào)檢出脂肪肝，393例（13.02%）自報(bào)檢出超重肥胖，238例（7.89%）自報(bào)檢出膽結(jié)石或膽囊炎，60例（1.99%）自報(bào)檢出貧血。49.13%的已被診斷為高血壓的老年人在年度體檢中的血壓值異常，高血壓老年人的血壓控制率為50.87%；糖尿病老年人在體檢中血糖異常率為60.48%，糖尿病老年人的血糖控制率為39.52%。多因素Logistic回歸分析結(jié)果顯示，糖尿病老年人血壓異常檢出率是一般老年人的2.57倍〔95%CI（2.01，3.29）〕，高血壓、糖尿病老年人血脂異常檢出率分別是一般老年人的1.64倍〔95%CI（1.29，2.08）〕、1.42倍〔95%CI（1.10，1.84）〕，高血壓、糖尿病老年人超重肥胖檢出率分別是一般老年人的2.79倍〔95%CI（1.94，4.00）〕、2.64倍〔95%CI（1.80，3.87）〕，高血壓老年人脂肪肝檢出率分別是一般老年人的2.10倍〔95%CI（1.55，2.85）〕，而高血壓、糖尿病老年人貧血檢出率則是一般老年人的0.25倍〔95%CI（0.13，0.47）〕、0.47倍〔95%CI（0.25，0.86）〕；農(nóng)村老年人的血脂異常、膽結(jié)石或膽囊炎檢出率分別是城市老年人的0.76倍〔95%CI（0.64，0.90）〕、1.32倍〔95%CI（1.01，1.73）〕（P<0.05）。 結(jié)論 基本公共衛(wèi)生服務(wù)的老年人體檢項(xiàng)目對(duì)老年人早發(fā)現(xiàn)、早知曉健康問(wèn)題具有重要的作用。

關(guān)鍵詞: 老年人, 老年人身心健康評(píng)價(jià), 體格檢查, 國(guó)家基本公共衛(wèi)生服務(wù), 健康促進(jìn)

Abstract:

Background

The contribution of geriatric health examination services of national essential public health services to the detection of abnormal health conditions in the elderly and the awareness of examination results of the elderly has been rarely reported in the current studies.

Objective

To investigate the abnormal detection of several common diseases including abnormal blood pressure, abnormal blood glucose, overweight and obesity, anemia, fatty liver disease, gallstones or cholecystitis in the health examination of the older adults aged 65 years and above.

Methods

The older adults aged 65 years and above who visited 20 primary care institutions in 5 cities of 3 provinces in eastern, central and western China were selected as study subjects (excluding those with unclear health examination results in this year) from November to December 2019 by using a multi-stage stratified sampling method, and divided into the general older adults (without hypertension or diabetes), older adults with hypertension, older adults with diabetes. A one-on-one questionnaire survey was conducted on all respondents (The questionnaire included the general demographic characteristics of the respondents and the abnormal detection in the health examination of the elderly) .

Results

Among 3 018 older adults, 2 033 (67.36%) reported abnormalities in the health examination. There were statistically significant differences in the abnormal detection rates of health examination for the older adults with different types of residence, population, and household registration (P<0.05). Among 3 018 older adults, 1 174 (38.90%) self-reported abnormal blood pressure detection, 747 (24.75%) self-reported abnormal blood glucose detection, 719 (23.82%) self-reported dyslipidemia detection, 445 (14.74%) self-reported fatty liver detection, 393 (13.02%) reported overweight and obesity detection, 238 (7.89%) reported gallstones or cholecystitis detection, and 60 (1.99%) reported anemia detection. Abnormal blood pressure was detected in 49.13% of the older adults diagnosed with hypertension during the annual health examination, with the blood pressure control rate of 50.87%. Abnormal blood glucose was detected in 60.48% of the older adults diagnosed with diabetes during health examination with the control rate of blood glucose of 39.52%. Multivariate Logistic regression analysis showed that the detection rate of abnormal blood pressure was 2.57 times〔95%CI (2.01, 3.29) 〕 higher in the older adults with diabetes than in the general older adults; the detection rate of dyslipidemia was 1.64 times〔95%CI (1.29, 2.08) 〕 and 1.42 times〔95%CI (1.10, 1.84) 〕 higher in the older adults with hypertension and diabetes than in the general older adults, respectively; the detection rate of overweight and obesity was 2.79 times〔95%CI (1.94, 4.00) 〕 and 2.64 times〔95%CI (1.80, 3.87) 〕 higher in the older adults with hypertension and diabetes than in the general older adults, respectively; the detection rate of fatty liver was 2.10 times〔95%CI (1.55, 2.85) 〕 higher in the the older adults with hypertension than the general older adults; while the detection rate of anemia was 0.25 times〔95%CI (0.13, 0.47) 〕 and 0.47 times〔95%CI (0.25, 0.86) 〕 higher in the older adults with hypertension and diabetes than in the general older adults; the detection rate of dyslipidemia, gallstones or cholecystitis was 0.76〔95%CI (0.64, 0.90) 〕and 1.32〔95%CI (1.01, 1.73) 〕 times higher in the rural older adults than the urban older adults, respectively (P<0.05) .

Conclusion

The physical examination program for the elderly in the national essential public health services plays an important role in early detection and wareness of health problems.

Key words: Aged, Geriatric assessment, Physical examination, National essential public health services, Health promotion

相關(guān)知識(shí)

【國(guó)家公共衛(wèi)生服務(wù)項(xiàng)目】——老年人體檢
【國(guó)家基本公共衛(wèi)生項(xiàng)目】老年人健康管理服務(wù)
【國(guó)家基本公共衛(wèi)生服務(wù)項(xiàng)目】老年人健康管理
國(guó)家基本公共衛(wèi)生服務(wù)項(xiàng)目老年人健康管理
國(guó)家基本公共衛(wèi)生服務(wù)項(xiàng)目老年人健康管理服務(wù)12問(wèn)12答
國(guó)家基本公共衛(wèi)生服務(wù)：老年人健康管理服務(wù)
【2022年國(guó)家基本公共衛(wèi)生服務(wù)項(xiàng)目3】老年人健康管理
國(guó)家基本公共衛(wèi)生服務(wù)項(xiàng)目—0
【定期體檢 守護(hù)健康】國(guó)家基本公共衛(wèi)生服務(wù)老年人健康體檢的好處
基本公共衛(wèi)生服務(wù)項(xiàng)目——老年人健康管理服務(wù)

網(wǎng)址: 國(guó)家基本公共衛(wèi)生服務(wù)老年人健康體檢的異常檢出率分析 http://www.u1s5d6.cn/newsview224452.html