網格化管理社區精神病患者的效果評價

孫一嬌 袁曉晴 潘宇峰 錢曉忠 高金麗

摘 要 目的：探討網格化管理在社區精神病防治中的意義。方法：選取上海市寶山區淞南鎮社區衛生服務中心自2007年來收治的本轄區內精神病患者665人，以2016年作為網格化管理起始年將患者分為網格化管理前464人和網格化管理后665人，對比網格化管理實施前后精神病患者家庭醫師簽約率、規范管理率、病情穩定率、服藥依從性率、肇事肇禍率、參加社區康復服務率、顯好人數和隨訪人數。結果：實施網格化管理后，精神病患者規范管理率、面訪率、家庭醫師簽約率，病情穩定率，服藥依從率、參加社區康復服務和參加正常工作的比例均得到提升，差異均有統計學意義（P<0.05）。結論：社區精神病防治施行網格化管理可以有效提高轄區內精神防治工作質量，促進患者疾病的好轉，提高患者生活質量，有助于更好地發揮社區衛生服務機構“守門人”的作用。

關鍵詞 精神??；網格化管理；社區

中圖分類號：R74 文獻標志碼：A 文章編號：1006-1533（2021）20-0038-04

Effect evaluation of grid management of community psychiatric patients

SUN Yijiao1， YUAN Xiaoqin1， PAN Yufeng1， QIAN Xiaozhong2， GAO Jinli1（1. Community Department of Songnan Community Health Service Center of Baoshan District， Shanghai 200441， China； 2. Medical Administration Department of Baoshan District Health Committee， Shanghai 201901， China）

ABSTRACT Objective： To explore the significance of grid management in community psychiatric prevention and treatment. Methods： Six hundred and sixty-five psychiatric patients in Songnan Community Health Service Center in Baoshan District of Shanghai since 2007 were selected， using 2016 as the starting year of grid management， the patients were divided into 464 patients before grid management and 665 patients after grid management， and before and after the implementation of grid management， the signing rate of family doctors， standardized management rate， disease stability rate， medication compliance rate， accident and disaster rate， participation rate of community rehabilitation services， number of people showing improvement and number of follow-up were compared. Results： After the implementation of grid management， the standardized management rate of psychiatric patients， the rate of face-to-face interviews， the rate of signing family doctors， the rate of stable illness， the rate of medication compliance， the proportion of participating in community rehabilitation services and participating in normal work all increased， and the differences were statistically significant（P<0.05）. Conclusion： The implementation of grid management in community psychiatric prevention and control can effectively improve the quality of psychiatric prevention and control work within the jurisdiction， promote the improvement of patients diseases and improve patients quality of life， which help to give better play to the role of "gatekeeper" of community health service institutions.

KEY WORD psychosis； grid management； community

精神病是指由各種原因引起的感知、情感和思維等精神活動的紊亂或者異常，導致患者明顯的心理痛苦和社會適應等功能損害[1-2]，如果沒有效的管理將會對社會穩定造成不利的影響。因此，需要全社會給予精神疾病患者更多的關懷和關注[3]。