| Health management were carried out for community residents in order to monitor, and analysis their risk of chronic disease completely, appraisal their condition of health, and guide their change the unhealthy lifestyle. Compare the changes in management group in many aspects after management, such as the changes in objective indicators, behavioral risk factors, and so on. Then compare the management group and control group in order to estimate the effect of the health management from comprehensive aspects and explore the effective community health management pattern for controlling chronic disease effectively.The residents who participate in the "Chronic Disease Community Intervention Project" by the Ministry of Health in the Community Health Center of Balizhuang and Jingsong at the period from October to December 2008 were selected by the study population. The residents who willing accept health management were assigned to the management group, and the people who unwilling accept health management, and age, gender, and time of participating in the project is the same to the management groups were assigned to the control group, and the two groups contain 1000 people respectively.The relevant informations were collected by the uniform questionnaire. The health management was carried out in the management group.And after 1 year, the relevant informations were collected again. Finally, the effect of the health management was evaluated by different populations; the general group used the self-comparison to evaluat the effect, and the high-risk group and the patients group used control group comparison to evaluate the effect. Use the Excel 2000 to register the data and the SPSS11.5 to analysis the data. 1. More women participated in the community health management than men, the women were 2.32 times for men; the average age of subjects is 60.57±0.50, and the people who over 50 years old accounted for 85.2%, the people who have hige school education or less accounted for 80%.62.7% of the subjects didn't work, and the retirees accounted for 88.6%. The subject group has high prevalence of chronic diasease, and Hypertension is the mainly disease, the prevalence rate of Hypertension was 55.8%.2. After the intervention, the average values of blood pressure, waist circumference and Body Mass Index (BMI) of general population were increased, but the changes weren't significant(P>0.05). the average values of Fasting Plasma Glucose (FPG), Total Cholesterol (TC), and Triglyeride(TG) were increased significantly(P<0.05).3. The effectiveness of the community health management in the high-risk group is as follows.3.1 In the population of High-normal Blood Pressure, the Systolic Blood Presssure(SBP) values of the two groups were increased, the change of management group was no significant(P> 0.05), while the change of control group was significant(P<0.05). The Diastolic Blood Pressure (DBP) values of two groups were significant decreased(P<0.05).3.2 In the overweight or obesity population, the BMI values of management group was decreased, and the BMI of control group was increased, but the change of two groups were no significant(P>0.05). In the central obesity population, the mean of waist circumference of the two groups in different gender were all decreased, the change were significant, except for the men of management group.3.3 In the population of Impaired Glucose Tolerance (IFG), the FPG values of management group were decreased significantly, but the FPG values of control group were no significant change.3.4 In the population of Dyslipidemia, the values of TC,TG, and LDL-C of management group were decreased, and the values of HDL-C of management group was increased, and the change of the LDL-C value was significant(P<0.05); the values of TC and LDL-C of control group were decreased, while the values of TG and HDL-C of control group were increased, the change of TC and LDL-C were significant(P<0.05).3.5 After 1 year health management intervention for the management group, the people of management group who intake beans, meat of livestock and fowl, salt, cooking oil and vegetable meet a criterion was increased, and the changes of salt intake were significant (P<0.05); the people of control group who intake beans, salt, cooking oil and vegetable meet a criterion were increased, while the people who intake meat of livestock and fowl was decreased, but the changes of this indexs weren't significant (P>0.05).4. The effectiveness of the community health management in the chronic diseases is as follows.4.1 The SBP of management group was decreased by 6.29±1.26 mmHg, while the SBP of control group was decreased by 2.72±1.46 mmHg; the change of management group is higher than the control group significantly (P< 0.05). The DBP of management group was decreased by 3.02±0.88 mmHg, the change was significant(P<0.05); the change of management group is higher than the control group, but the change between management group and control group was no significantly difference (P>0.05).4.2 The BMI and waist circumference of management group and control group were significantly higher than baseline (P< 0.05), but the difference between the management group and control group was no significant (P>0.05).4.3 The rate of people of management group who intake cereals, salt and cooking oil meet a criterion accounted for were increased by 10.0%,11.5% and 10.2% respectively, the differences were all significant (P<0.05), While the former indexes of control group were increased by 4.5%,2.1% and 4.6% respectively, the differences were not significant (P>0.05), the dietary intake of management group after the intervention is more reasonable than control group.4.4 After the intervention, the awareness, treatment and the rate of control on hypertension among the management group were increased significantly (P<0.05), and the effect is the most obvious in the people who below the 60 years old. 1. Health management can reduce risk factors of the chronic disease, especially in the aspect of improving unreasonable meal intake among the high risk group and the patients with chronic disease, such as unreasonable dietary pattern, high-salt diet, high-fat diet, and so on.2. Community health management can improve the awareness, treatment and the rate of control on hypertension, the most obvious effectiveness was happened in the people who below 60 years old.3. Health management is benefit for maintaining healthy weight, and controlling the increase trend of overweight or obesity effectively. |
