网格化管理社区精神病患者的效果评价

孙一娇 袁晓晴 潘宇峰 钱晓忠 高金丽

摘 要 目的：探讨网格化管理在社区精神病防治中的意义。方法：选取上海市宝山区淞南镇社区卫生服务中心自2007年来收治的本辖区内精神病患者665人，以2016年作为网格化管理起始年将患者分为网格化管理前464人和网格化管理后665人，对比网格化管理实施前后精神病患者家庭医师签约率、规范管理率、病情稳定率、服药依从性率、肇事肇祸率、参加社区康复服务率、显好人数和随访人数。结果：实施网格化管理后，精神病患者规范管理率、面访率、家庭医师签约率，病情稳定率，服药依从率、参加社区康复服务和参加正常工作的比例均得到提升，差异均有统计学意义（P<0.05）。结论：社区精神病防治施行网格化管理可以有效提高辖区内精神防治工作质量，促进患者疾病的好转，提高患者生活质量，有助于更好地发挥社区卫生服务机构“守门人”的作用。

关键词 精神病；网格化管理；社区

中图分类号：R74 文献标志码：A 文章编号：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、情感和思维等精神活动的紊乱或者异常，导致患者明显的心理痛苦和社会适应等功能损害[1-2]，如果没有效的管理将会对社会稳定造成不利的影响。因此，需要全社会给予精神疾病患者更多的关怀和关注[3]。