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ObjectivesTo investigate characteristics and influencing factors of short-term variation of systolic blood pressure of community hypertension patients in Shanghai. MethodsBased on the standardized blood pressure measurement data of hypertensive patients in Shanghai （2018‒2021） and the noninfectious chronic disease management system database， coefficient of variation of systolic blood pressure （CV_S） was described and the influencing factors were analyzed. ResultsAmong 112 680 community hypertension patients， males accounted for 46.87% with a median age of 69 years. CV_S was 0.038 6 ± 0.035 0. Generalized linear model analysis showed the following influencing factors of CV_S： gender， females were higher than males， B=0.032， P<0.001； age group， 60‒69 years， 70‒79 years old group， and ≥80 years groups were all higher than <50 years group， B=0.042， 0.056， and 0.074 respectively with P values of 0.020， 0.002， and <0.001 respectively； smoking， smoking cessation and smoking everyday was lower than never smoking， B=-0.032 and-0.028 respectively with P values of 0.023 and 0.007 respectively； systolic blood pressure， 140‒159 mmHg group， 160‒179 mmHg group， and ≥180 mmHg group were lower then <140 mmHg group， B=-0.039， -0.091， and -0.175 respectively with P values all <0.001； and measurement season， autumn was lower than spring， （B=-0.056， P<0.001）. The paired test showed that CV_S calculated from the three measurements was 1.04% higher than that calculated from the two measurements （P<0.001）. ConclusionThe coefficient of variation of systolic blood pressure of community hypertension patients in Shanghai has large variation， and was influenced by many factors.
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China’s chronic disease management suffers from problems such as unclear institutional function， insufficient information technology application， and weak regulation support. On the basis of current chronic disease management condition in China， this paper proposes to apply the concept of “people-centered” integrated health management to community chronic disease management and discusses the content and procedure of establishing an integrated community-based chronic disease management model driven by massive databases. The model innovatively combines technology integration， data integration and service integration， and can accurately and efficiently realize the "people-centered" full-course health management of various chronic diseases. Shanghai has provided integrated community-based chronic disease management service for 1.98 million citizens through applying this model. The model warrants further effectiveness and economic evaluation. This study provides precious experience for the development of chronic disease prevention and treatment in China.
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ObjectiveTo evaluate the effect of standardized blood pressure measurement in consulting room （SBPM） model on blood pressure screening of non-hypertensive patients in community. MethodsFour communities were randomly selected from Fengxian District of Shanghai， and non-hypertensive patients in the communities were included for screening. Based on the communities， participants were further classified into the intervention group and control group. A one-year intervention study was conducted from January 1， 2021 to December 31， 2021. The intervention group received the intervention measures of standardized measurement， and the control group remained the routine measurement. The distribution of blood pressure values and last digit of the values between the intervention group and control group were tested using Chi-square test and normality test. Then changes in abnormal blood pressure rate before and after the intervention were determined by double difference method. Statistical analysis was performed using SPSS 20.0. ResultsA total of 15 368 participants were included in the intervention group， and 19 811 participants in the control group. After the intervention， range of the last digit of blood pressure values in the intervention group was 9.55%‒10.41%， of which that of systolic and diastolic blood pressure were equally distributed （P=0.932 and 0.871， respectively）. The range of the last digit in the control group was 1.31%‒42.58%， of which that of systolic and diastolic blood pressure showed unequal distribution （P<0.001）. Through one-year standardized measurement intervention， the abnormal rate of blood pressure in the intervention group was 26.29%， which was 7.61 times as high as that in the control group （OR=7.55， 95%CI： 6.75‒8.57， P<0.001）. ConclusionStandardized blood pressure measurement in consulting room is suitable for the screening of blood pressure measurement in community， which has higher data quality than that of routine measurement.
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Objective:To analyze the influenza vaccination status of chronic disease management patients in Qingpu district of Shanghai and the vaccination characteristics of different characteristic populations, so as to provide scientific basis for improving the influenza vaccination rate of chronic disease patients in the community.Methods:By comparing the data of Shanghai chronic disease management information system, immunization planning information system and medical association platform, 89 453 subjects who met the inclusion and exclusion criteria in Qingpu district were selected as the research objects. The vaccination coverage rate of the study subjects was calculated according to gender, age group, urban and rural distribution, occupation, chronic disease type and quantity, and the vaccination coverage rate of different subgroups was compared to analyze the influencing factors of vaccination coverage rate.Results:Most of the 89 453 patients with chronic diseases were 60 years old and above (71.93%). Patients with hypertension, diabetes, chronic obstructive pulmoriary disease (COPD) and three chronic diseases accounted for 87.12%, 28.67%, 8.71% and 1.83%, respectively. Influenza vaccination coverage in the 2016/2017 flu season was low, at 0.32%. Influenza vaccination coverage rate of women (0.37%) was higher than that of men (0.27%), which was 1.41 times respectively(95% CI: 1.16, 1.72) that of men patients. The coverage rate of influenza vaccination for the 70-79 year-old group was the highest (0.74%), which was 1.74 times respectively(95% CI: 1.39, 2.19) that of 60-69 year-old patients. The vaccination coverage rate of government departments and institutions was the highest (1.14%), which was 12.58 times respectively(95% CI: 4.52, 34.99) that of retirees. The vaccination rate of COPD patients (3.68%) was 2.50 times (95% CI: 1.66, 3.77) higher than that of patients without COPD.Conclusions:Influenza vaccination rate for chronic disease management patients in Qingpu district of Shanghai is low. Gender, occupation, age and types of chronic diseases are the influencing factors. Patients with chronic disease management should be included in the priority vaccination targets for influenza vaccines, and vaccination intervention for occupational chronic diseases such as non-retired agriculture and forestry patients, especially male patients, should be strengthened to improve influenza vaccination coverage rate.
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Objective To investigate prevalence of chronic diseases, and the awareness & attitudes, and the health demand of residents aged ≥18 yrs in Shanghai communities. Methods 2 320 residents aged over 18 yrs were selected from 19 communities by multiple stage cluster sampling and questioned by face to face survey. Results The standardized self-reported prevalence rate of whole chronic diseases was 28.4%, hypertension was 21.8%, osteoporosis was 7.0%, diabetes mellitus was 6.3%, respectively, which were ranked the top three. The awareness of the hypertension and diabetes mellitus were accounted to 89.3% and 86.0%. The demands for the convenient and comfortable clinical environment in residents accounted to 80.6%. Conclusion The prevalence of chronic diseases in Shanghai was high. It's suggested to enhance the control and prevention of chronic diseases, particularly on hypertension, and to do more health education in suburbs.