基于流程再造的中青年高血压社区O2O健康管理服务路径研究

The prevalence of chronic diseases in China is rapidly rising, in which the morbidity of hypertension of the young and middle-aged increases more dramatically than the elderly. .Previous investigation found a trend that mobile health technology, like the mobile phone APP(application), is gradually applied to the management of chronic diseases in communities with the development of mobile internet, and the young and middle-aged more frequently focus on its application. The application of new technologies will revolute traditional management path, though health management based on O2O (Online to Offline) mode is still on its initial stage and lack of standard guidance. Therefore, this study will explore the establishment of O2O health management service path of the young and middle-aged with hypertension in community, which includes three stages: the basic information analysis and path designing, the empirically application of the path, and the evaluation and optimization of the path. .Firstly, we adopt the methods of participant observation and investigation to summarize the characteristics of the young and middle-aged and analyze the predicament in implementing current service path. Secondly, based on the process reengineering theory, the health management service path of O2O mode will be designed by employing the methods of participant evaluation and focus interview, and modified by the PDCA(Plan-Do-Check-Action cycle) model and pre-experiment. Thirdly, we perform the empirical study with the usage of a randomized controlled trial. Finally, the process of the path and practical application effect are evaluated. .The results of this research will provide technical support and reference for regularizing the O2O health management service path of the young and middle-aged with hypertension in community and improving the national basic public health services.

我国慢性病发病率快速攀升，中青年高血压患病率的增高趋势比老年人更明显。前期研究发现，随着移动互联网发展，以手机APP为代表的移动健康技术用于社区慢性病管理已成为一种趋势，中青年乐于使用该技术。新技术的使用，将颠覆传统健康管理路径，但线上与线下（O2O）相结合的社区健康管理尚缺乏科学、规范路径的指导。本课题研究中青年高血压社区O2O健康管理服务路径，研究分三阶段：路径设计前的基础信息分析、设计、设计后的实证与评价及优化。首先，运用参与性观察法、调查法，分析现行服务路径实施的难点及中青年高血压患者的特点；其次，基于流程再造理论，采用参与性基层评估法、焦点组访谈法，设计O2O服务路径，并运用PDCA模型，通过预试验修订；最后，采用随机对照试验，进行实证研究，并开展路径的过程和结果评价、优化。研究结果将为规范和推进中青年高血压社区O2O健康管理及完善国家基本公共卫生服务规范提供一定技术支持与参考。

近年来，我国慢性病发病率快速攀升，成为重大公共卫生问题。不断提高慢性病的管理率和控制率是一项长期工作，也是中国政府改善民生、推进医改的重要内容。随着移动互联网技术的高速发展，移动健康技术用于社区慢性病防控工作，已经成为一种趋势。新技术的使用将颠覆传统慢性病健康管理的流程，在此过程中，不可避免地需要对传统业务流程做出改变。前期研究发现，中青年高血压患病率的增高趋势比老年人更明显，以手机APP为代表的移动健康技术用于社区慢性病管理已成为一种趋势，中青年乐于使用该技术，但线上与线下（O2O）相结合的社区健康管理尚缺乏科学、规范路径的指导。本课题研究中青年高血压社区O2O健康管理服务路径，研究分三阶段：路径设计前的基础信息分析、设计、设计后的实证与评价及优化。首先，运用参与性观察法、调查法，分析现行服务路径实施的难点及中青年高血压患者的特点；其次，基于流程再造理论，采用参与性基层评估法、焦点组访谈法，设计O2O服务路径，并运用PDCA模型，通过预试验修订；最后，采用随机对照试验，进行实证研究，并开展路径的过程和结果评价、优化。研究结果将为规范和推进中青年高血压社区O2O健康管理及完善国家基本公共卫生服务规范提供一定技术支持与参考。

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