关键词: 高血压, 系统动力学, 社区卫生服务, 健康管理

Abstract: Background　At present，single index method，multiple linear regression，grey model and ARIMA model make mostly use of studying the management effect of chronic diseases in communities.These methods often depend on the completeness of data indicators and the length of time series.We present the application of the system dynamics model，which the simulation results are closer to the real situation and the data requirements are more relaxed.This study provides a new method for decision optimization of single disease management path in community.Objective　To explore a dynamic complex model for community-based management pattern of hypertension，providing a reference for quantitative research on the effect and improvement of community-hypertension management pattern.Methods　From January to May 2017，by use of semi-structured interviews with the front-line key health workers of Xuhui District Fenglin Community Health Center，Shanghai，we obtained the data concerning the process of hypertension management used in this center，and we collected the data regarding community-based hypertension management between 2015 and 2017 by web searching.Using systems thinking approach and system dynamics modeling software，we constructed a systems thinking models of community-based hypertension management on the basis of the interview results，literature review of the collected study data and policy documents，and drew causal loop diagrams using the identified key factors in the management system among which causal relationships exist.Results　The system of hypertension community-based hypertension management pattern includes community-dwelling population classification subsystem，high-risk population for hypertension management subsystem，hypertension population management subsystem and community input subsystem.The causal relationships between the factors included in the community-based hypertension management pattern are explained well by the causal loop diagrams of quantity control of targeted populations under community-based hypertension management and quality control in community-based hypertension management for targeted populations.Conclusion　The systems thinking models of community-based hypertension management can be used as an important assistant tool for assessing the performance of the standardized community-based hypertension management system and for optimizing the management procedure.Moreover，the systems thinking models and causal loop diagrams provide references for the development of community-based management patterns of other single diseases.

Key words: Hypertension, System dynamics, Community health services, Health management