| Objective:In order to provide scientific basis for community doctor choose economic and efficient health education intervention plan and provide the economic foundation of practicability for government decision-making. It compared with regular health education, provided the effectiveness indicator of comprehensive evaluation to different health education pattern and did cost effectiveness comparison to community health education management intervention of current IGR patients.Method:The intervention group was IGR patients who intended to attend community health education management at Xinqiao Street, SongjiangDistrict, Shanghai City. The control group was IGR patients who come from Yongfeng Street and Maogang Street where economic level and medical care level were similar with Xinqiao. The control group adopted traditional health education pattern which was doctor communicated with patients by face to face when they were doing randomly visit. The intervention group live patterns was intervened by force and the specific method was effective live pattern intervention made BMI reached or approached to 24.The total daily heat would reduced 400-500cal at least and saturated fatty acid intake occupied no more than 30% of whole fatty acid and physical activity increased 250～300 minutes per week. The health education management frequency of control group was one time per half a year and the intervention group was one time per two months which whole time was a year. It did economic effectiveness evaluation to different health education management patterns. It investigated the common situation and intervention effectiveness indicator of patients before and after intervention and the cost during intervention. It did comparability analysis to basic datum between intervention group and control group. It applied SPSS 16.0 software to do the statistical analysis. It demonstrated that the descriptive statistic of measurement data with mean value+/-standard deviation and enumeration data with rate or composition. The comparison of measurement data with ’t’ inspection and the rate comparison with x2 inspection etc.. The significance of statistic existed with P<0.05 as the difference.Result:1) It did the comparison to basic datum between intervention group and control group and the research object had the comparability of basic datum on social demography, the level of health knowledge and the severity of disease.2) The level of health knowledge was promoted after intervention and the difference had statistic significance (P<0.05). There were some improvement on diet adjustment, reduced the behavior of smoking, reduced the behavior of drinking and did suitable physical exercise after intervention, so it had statistic significance since difference existed before and after intervention (P<0.05). But the improvement of control group was not obvious, so the difference didn’t have the statistic significance since P>0.05. The BMI indicator decreased 1.45 kg/m2, the WHR indicator decreased 0.02, DBP indicator decreased 3.280mmHg, TC decreased 0.38mmol/l, TG decreased 0.37mmol/l, FGH decreased 0.35mmol/l,2hPG decreased 0.35mmol/l of intervention team. The difference of before and after intervention had statistic significance (P<0.05). The difference of each indicator of control group didn’t have the statistic significance (P>0.05). All indicator of intervention group dropped compared with control group. All indicator difference of intervention group and control group had the statistic significance (P<0.05). The IGR patients of intervention group change to diabetes rate was 5.5% and the IGR patients of control group change to diabetes rate was 11.3% whose difference had statistic significance (P<0.05) after intervention a year. The IGR patients of intervention group change to normal rate was 53% and the control group was 42.8% whose difference had statistic significance (P<0.05) after intervention a year.3) The result of medical economics evaluation:The overall average cost of each intervention group IGR patient was 90.59 yuan and the control group was 73.69 yuan after intervention a year. The cost of comparison group decreased FPG lmmol/1 was 2007.9 yuan and decreased 2hPG lmmol/1 was 443.15 yuan. The cost of intervention group decreased FPGlmmol/1 was 259.05 yuan and decreased 2hPG 1mmol/1 was 257.87 yuan. The cost of each indicator got the effectiveness of each patient of intervention group was lower than each patient of control group. The ratio of increased cost effectiveness demonstrated that the intervention group needed increased cost was 53.99 yuan when decreased FPG lmmol/1 and needed increased cost was 91.35 yuan when decreased 2hPG 1mmol/1 compared with control group. Compared to the control, IGR each intervention group transformation of a percentage point less in diabetic patients, the need to spend the cost of 2.91 yuan, the intervention group IGR every one percentage point more than the normal transition, the need to spend the cost of 1.66 yuan.Conclusion:The economics evaluation of community health education management to IGR patients demonstrated that the force intervention to live patterns was deserved to be spreaded since its cost was low and effectiveness was good. |
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