ABSTRACT
Objective@#To evaluate the cost-effectiveness of intervention and management of the patients with dyslipidemia in some districts in Shenzhen and provide health economic basis for prevention and control of dyslipidemia.@*Methods@#We conducted a comprehensive community intervention among patients for dyslipidemia management, enrolling 204 cases of dyslipidemia in the intervention group and 200 cases in the control group through multi-stage cluster random sampling. We collected baseline and intervention data, such as the cost of institutional intervention (labor costs, office expenses, material expenses, loss of low-value consumables, service costs, and depreciation of fixed assets), patient costs (direct and indirect medical costs), effect indicators (lipid control rate, lipid improvement rate, and lipid exacerbation rate) to analyze cost-effectiveness.@*Results@#After 12 months of the comprehensive community intervention, the total cost for the intervention group was 1 321.62 yuan per capita; the cost per patient was 973.33 yuan; and per capita institutional cost was 348.29 yuan. Total cholesterol, triglyceide, and high-density lipoprotein cholesterol of intervention group decreased by 0.43 mmol/L, 0.16 mmol/L, and 0.42 mmol/L, respectively, after the intervention, and there was a significant difference before and after the intervention (P<0.05). After intervention, the intervention group lipid control rate was 17.6%, the lipid improvement rate was 48.0%, and the lipid exacerbation rate was 7.4%, whereas those of the control group were 10.5%, 22.5%, and 16.0%, respectively. The lipid control rate and improvement rate in the intervention group were higher than those in the control group, and the lipid exacerbation rate was lower than that of the control group. The difference between the two groups was statistically significant (χ2=43.774, P<0.001). Patients in the control group had a unit cost of 81.17 yuan for 1% of blood lipid control rate and 37.88 yuan for one unit of blood lipid improvement rate. The corresponding per capita cost of the intervention group was 74.87 yuan and 27.51 yuan, respectively. The intervention group's cost-effect ratio was lower than that of the control group and had good cost-effectiveness.@*Conclusions@#The comprehensive community intervention and management of patients with dyslipidemia was effective in terms of health economics and it is worth the long-term implementation and promotion in the community health service center.
ABSTRACT
Objective To study the effects of salt and cooking oil intervention among hypertensive patients on knowledge-attitude-practice. Method Three thousand hypertensive patients from 20 community health service centers in Shenzhen were chosen by multi-stage cluster random sampling method. Salt measuring spoons and scaled oil pots were provided during six-month health intervention. Before and after the six-months health intervention, 2 976 and 2 864 valid questionnaires were collected respectively. After intervention, 40 families were randomly selected to perform an investigation of cooking oil and salt weighing during 3 d 24 h. Result Before the intervention, the rates of awareness on the intake of salt and cooking oil were 29.94% and 16.23% respectively. After intervention, the rates increased to 88.58% (P<0.000 1) and 84.29%(P<0.000 1) respectively. The rates of restriction on the intake of salt and cooking oil were 62.97% and 59.07%, respectively, after the intervention, the rates were 97.14% and 96.79% (P<0.000 1), respectively. By using the salt measuring spoons and scaled oil pots, the intake of cooking oil and salt reached the recommended amount in Chinese dietary guideline. Conclusion The implementation of health education combined with appropriate tools could promote the knowledge and behavior of the salt and cooking oil consumption.