Brugulat P, Mercader M, Séculi E
Unidad Plan de Salud y Evaluación, Servicio Catalán de la Salud, Barcelona.
Aten Primaria. 1998 Oct 15;22(6):334-9.
To find how much the detection of two factors of cardiovascular risk, over-consumption of alcohol and anti-tetanus vaccination, has been incorporated into clinical practice in the treatment of adults in the primary care reform; and to what extent the objectives on these questions of the Health Plan for Catalonia 1993-1995 were met.
A descriptive crossover study of a sample of primary care clinical histories (PCCHs).
A random sample of 3000 PCCHs of patients aged 15 and over attended during 1995 in the Health Districts in Catalonia which had been in operation for over three years.
The following data were obtained from the PCCHs: patients' age and sex, whether blood pressure values were recorded, cholesterol levels, glucose levels, weight, size, tobacco habit, alcohol consumption, antitetanus vaccination and explicit documentation of diagnoses in relation to risk factors studied. The results showed that recording was above the level established in the Plan for cholesterol levels (64.4%), glucose levels (72.1%) and tobacco habit (66.5%); and slightly below, for blood pressure (57.8%) and alcohol consumption (9.6%). Among the youngest of the target population, detection was less common, especially for tobacco habit and alcohol consumption. Antitetanus vaccinations were recorded in 24.3% of the PCCHs.
In general the objectives set in the plan have been reached. The detection of cardiovascular risk factors and over-consumption of alcohol was adequate for the target population groups established. Antitetanus vaccination is the preventive activity with the least compliance.
探究在初级保健改革中,心血管疾病风险的两个因素(过度饮酒和破伤风疫苗接种)的检测在成人治疗的临床实践中得到了多大程度的应用;以及1993 - 1995年加泰罗尼亚健康计划中关于这些问题的目标在多大程度上得以实现。
对初级保健临床病史(PCCHs)样本进行描述性交叉研究。
1995年在加泰罗尼亚运营超过三年的健康区中,随机抽取3000份15岁及以上患者的初级保健临床病史。
从初级保健临床病史中获取以下数据:患者的年龄和性别、是否记录血压值、胆固醇水平、血糖水平、体重、身高、吸烟习惯、饮酒情况、破伤风疫苗接种情况以及与所研究风险因素相关的明确诊断记录。结果显示,胆固醇水平(64.4%)、血糖水平(72.1%)和吸烟习惯(66.5%)的记录高于计划规定的水平;而血压(57.8%)和饮酒情况(9.6%)的记录略低于计划水平。在目标人群中最年轻的群体中,检测不太常见,尤其是吸烟习惯和饮酒情况。24.3%的初级保健临床病史记录了破伤风疫苗接种情况。
总体而言,计划设定的目标已经实现。对于既定的目标人群组,心血管疾病风险因素和过度饮酒的检测是足够的。破伤风疫苗接种是依从性最低的预防活动。