基于ICCC框架的山东省农村高血压健康管理模式的质性研究

BackgroundThe prevalence of hypertension in rural areas in China is very serious, and the prevention and control of hypertension in rural areas is particularly important. ObjectiveBased on Innovative Care for Chronic Conditions Framework (ICCC) proposed by WHO, we summarized the characteristics and shortcomings of the rural hypertension health management model in Shandong Province and put forward targeted recommendations. MethodsA total of 9 towns and 36 villages were selected form A county of Heze, B district of Jinan and C city of Weihai in Shandong Province bystratified sampling method. And semi-structured interview method was used to conduct face-to-face interviews with 84 respondents, including hypertension managers, medical staff at all levels and hypertension patients. NVivo 12 software was used to encode and analyse the interview texts around the macro, meso and micro elements of the ICCC. ResultsAt the macro level, the management of rural hypertension in Shandong Province was generally in a positive policy environment, such as implementing national policies of chronic diseases and publicizing chronic disease management, but the policy system framework was not complete, the integration within the health system was poor, the shortage of hypertension management professionals and the lack of financial support were prominent; At the meso level, medical institutions at all levels strived to promote the continuity of medical services, but the organization and deployment of family doctor team and the use of information systems still needed to be further strengthened; At the micro level, the cooperation and enthusiasm of patients, families and family doctor team needed to be improved. ConclusionGive full play to the leadership and supervision role of the government,formulate and integrate relevant policies, promote the integration of various departments; increase financial support, and make up for the relatively lack of health human resources and weak information construction in rural areas to promote high-quality medical services; attach importance to the tripartite interaction between patients and families, health service team and community partners to promote patients' self-management.