Volume 22 Issue 11
Nov.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(11): 1899-1903
ZHOU Yingda, JIN Hua, YU Hao, CHEN Chen, QIU Baohua, SHI Ling, YU Dehua. Analysis of chronic disease management implementation in community health service center in Shanghai[J]. Chinese Journal of General Practice, 2024, 22(11): 1899-1903. doi: 10.16766/j.cnki.issn.1674-4152.003760
Citation: ZHOU Yingda, JIN Hua, YU Hao, CHEN Chen, QIU Baohua, SHI Ling, YU Dehua. Analysis of chronic disease management implementation in community health service center in Shanghai[J]. Chinese Journal of General Practice, 2024, 22(11): 1899-1903. doi: 10.16766/j.cnki.issn.1674-4152.003760
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Analysis of chronic disease management implementation in community health service center in Shanghai

doi: 10.16766/j.cnki.issn.1674-4152.003760
  • 1.

    The Community Health Service Center of Zhenru Town, Putuo District, Shanghai 200333, China

Funds:

 72104183

 YDH-20170627

 Ye2202103

  • Received Date: 2024-06-12
    Available Online: 2024-12-31
    Abstract
  •   Objective  To investigate the overall implementation of chronic disease management in community health centers in Shanghai, and to assess and improve the current status of chronic disease management in community health centers in Shanghai.  Methods  In July 2022, a total of 247 community health centers in Shanghai were selected for analysis. A descriptive analysis was conducted on data related to chronic disease management, including objective quality control data and subjective questionnaire surveys, sourced from the Shanghai Clinical Quality Control Center of Family Medicine.  Results  A total of 238 community health centers participated in the study, 96.2%(229 centers) had established clear assessment criteria for chronic disease management, primarily focusing on patient satisfaction, health literacy questionnaire completion rates, and patient return visit rates. In the study, 98.3% of the 234 social health centers had a chronic disease management system, but only 67.2% of them regularly update their data, and 29.8% of them had incomplete information records. Taking hypertension management as an example, 90.7% of centers maintained standardized health records for patients, and follow-up visits were conducted in all communities. The current needs of social guards in implementing chronic disease management mainly include individualized management experiences, mobile management tools, risk assessment methods, and referral platforms. The main difficulties encountered in the implementation process included cumbersome information processing, inconsistent patient management, excessive time requirements, and complex assessment standards.  Conclusion  A community-centered chronic disease management model has been established, but attention is needed to address existing challenges. To enhance awareness and ability in chronic disease management, it is essential to optimize training and evaluation system of chronic disease management, accelerate the standardization of primary healthcare information, and strengthen supportive tools for chronic disease management within the community in multiple dimensions.

     

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