关键词: 社区卫生服务, 基层医疗卫生机构, 呼吸系统, 疾病管理

Abstract: Objective　To explore the chronic respiratory disease management in grassroots medical institutions of China.Methods　We conducted an online questionnaire survey among the managers of 48 community health centers/township hospitals as well as 413 community health stations/village clinics in Weifang，Shandong Province during December 2015 to January 2016 for collecting the data concerning screening，health record documentation，follow-up，health education，and professional trainings for health workers of 3 chronic respiratory diseases〔chronic obstructive pulmonary disease（COPD），bronchial asthma（AS），obstructive sleep apnea hypopnea syndrome（OSAHS）〕，diabetes and hypertension.The proportion of each type of institutions involved in the management of the 3 chronic respiratory diseases，diabetes and hypertension were calculated and compared.Results　Of the community health centers/township hospitals，27.1%（13/48）carried out the screening of COPD，2.1%（1/48）and 4.2%（2/48） documented health records for COPD and AS patients，12.5%（6/48）and 14.6%（7/48）provided follow-up services for COPD and AS patients，14.6%（7/48），16.7%（8/48） and 0 offered health education for COPD，AS and OSAHS patients，12.5%（6/48），12.5%（6/48） and 4.2%（2/48）conducted professional trainings for health workers for the management of COPD，AS，and OSAHS patients，and all of them were much lower than the corresponding proportions for the management of diabetes as well as hypertension（P<0.001）．Among the community health stations/village clinics，11.4%（47/413） conducted the screening of COPD，3.9%（16/413） and 3.6%（15/413） documented health records for COPD and AS patients，6.8%（28/413）and 4.1%（17/413）offered follow-up services for COPD and AS patients，11.4%（47/413），10.9%（45/413）and 5.8%（24/413）provided health education for COPD，AS and OSAHS patients，15.3%（63/413），10.9%（45/413）and 3.1%（13/413）implemented professional trainings for health workers for the management of COPD，AS，and OSAHS patients，and all of them were significantly lower than the corresponding proportions for the management of diabetes as well as hypertension（P<0.001）．Conclusion　Compared with diabetes and hypertension，the scale of standardized management of chronic respiratory diseases in grassroots medical institutions in Weifang is relatively small.In order to improve the chronic respiratory disease management，primary care providers should be trained with corresponding specialty knowledge comprehensively，lung function tests should be popularized in grassroots medical institutions，public health education should be carried out extensively，policy support for the prevention and control of chronic respiratory diseases should be further intensified and the construction of web-based prevention and control system of chronic respiratory diseases should be promoted.

Key words: Community health services, Primary medical institutes, Respiratory system, Disease management