Study On Current Situation And Management Measures Of Chronic Diseases In Taicang City

Objective:The population-based survey is designed to investigate the prevalence and distribution of main chronic diseases in Taicang city,to explore the influencing factors and to provide scientific basis for effective prevention and reduction of the burden of chronic diseases for the improvement of residents’ health.Methods:The random cluster sampling method was used to investigate the resident population aged 18 years and above,living for at least 6 months in Taicang city.The actual cases investigated were 1,1025,and the effective questionnaires were 10809,resulting in a 98.04%response rate.A questionnaire survey and main physical examination were carried out.Epidata3.1 was used for data entry,Excel and SPSS 18.0 were used for descriptive analysis,and chi-square test and non-conditional multiple Logistic regression were used for risk factor analysis.Results:1.Prevalence of major chronic diseases:self-reported prevalence rate of hypertension,diabetes,hyperlipemia,coronary heart disease,stroke,tumor and chronic obstructive pulmonary disease was 28.99%,6.57%,4.71%,2.03%,3.42%,1.23%and 0.81%,respectively.Among them,the adjusted prevalence rate of hypertension,diabetes and hyperlipidemia was 15.81%,3.87%and 3.03%,respectively according to the population age structure of Taicang city in 2015 and the adjusted prevalence rate of the three diseases was 12.91%,3.24%,2.71%,respectively according to the age structure of the national census in 2000.A further physical examination showed the actual prevalence rate of hypertension and diabetes was 35.65%and 9.03%respectively,the adjusted prevalence rate was 20.40%and 5.42%according to the population age structure of Taicang city,and the adjusted prevalence rate was 16.94%and 4.57%respectively according to the age structure of the national census in 2000.Thus,the awareness rate of hypertension and diabetes was 81.34%and 72.64%,respectively.2.Independent risk factors for hypertension,diabetes,hyperlipemia:independent risk factors for hypertension were men,middle-aged and elderly,centripetal obesity,overweight and obesity,family history,specifically the family of one or both parents,children,siblings with high blood pressure,frequent drinking,poor psychological status,poor sleep quality,mild taste and salty taste.Protective factors for hypertension were moderate and high education level,moderate and severe physical activity,eating more than 200 grams of fruit,less than 200 grams of animal food per day,five to seven times of soy products a week and sweety taste.Independent risk factors for diabetes were men,middle-aged and elderly,centripetal obesity,overweight and obesity,family history,specifically the family of one or both parents,children,siblings with diabetes,poor sleep quality,poor psychological status,eating more than 250 grams of vegetables per day,and a mild taste.Protective factors for diabetes were moderate physical activity,eating more than 100 grams of fruit per day and a sweety taste;Independent risk factors for hyperlipidemia were middle-aged and elderly,middle and higher education levels,centripetal obesity,overweight and obesity,smoking cessation,poor sleep quality,general psychological status,and a salty taste.Protective factor of hyperlipidemia was moderate physical activity.3.Burden of chronic diseases:the rate of medicine-taking rate of patients with hypertension and diabetes was 98.25%and 93.09%,respectively.The rate of measuring blood pressure and blood glucose by doctors within 3 months was 79.10%and 76.73%,respectively Control rate of hypertension and diabetes was 48.34%and 29.34%,respectively.7.07%of the total population had been hospitalized due to illness in the past year.The mean hospital stay was 18.18 days.The average hospitalization cost was 21,656.69 yuan,of which the average self-paid part was 7,704.57 yuan.4.Early detection of chronic diseases:in the past three years,58.17%of respondents took a physical examination annually,while 20.35%of them never undergo medical tests.The probability of measuring body weight,blood pressure and blood sugar was 39.05%,44.59%and 11.06%each quarter,while 7.56%,11.58%and 30.65%of them were never measured.Conclusion:1.Self-reported prevalence rate and actual prevalence rate of several major chronic diseases were all lower than that of provincial and national levels.The awareness rate of hypertension and diabetes was higher than that of the provincial level.2.Independent risk factors for several major chronic diseases can be divided into non-changeable factors(such as gender,age,etc.)and variable factors(such as lifestyle and behavior habit).3.Patients with hypertension and diabetes have higher medication rate,but lower control rate.Self-paid medical expenses account for one-third of the total hospitalization costs.4.More than half of the respondents participated in the physical examination every year,whereas measurement of weight,blood pressure and blood sugar rate every 3 months were low.Thus the early detection of chronic diseases through physical examination was poor.The results show that effective comprehensive intervention should be carried out for the major variable factors of chronic diseases,such as smoking,drinking,physical activity and dietary habit,to reduce the risk factors of chronic diseases.In addition,the standardized management of chronic diseases should be strengthened to improve patients’ treatment compliance and treatment rate and control rate of chronic diseases,reduce and control complications,disability rate and mortality of chronic diseases,and ensure the overall health level of the population.