[AbstraCt] ObjeCtive To evaluate the effects of management based on regional medical association in community hypertension patients. Methods In January,2011,600 patients with essential hypertension were enrolled as observation group randomly chosen from the chronic disease management information system in A community health service organization. Using the same method,another 512 patients with essential hypertension were enrolled as control group from B community health service organization. Routine diagnosis and treatment were used in the control group,while the related mechanisms of the regional medical association were used in the observation group in addition of the routine diagnosis and treatment. The follow _ up time was 3 years. The standardized management(visiting rate,management rate and control rate of blood pressure)and patientsˊ behavior changes(medication compliance,salt _ intake control,drinking and smoking)and the averaged monthly medical expenses were compared between the two groups both before and after the intervention. Results Before intervention,no significant differences were found in medication compliance,salt _ intake control,smoking and drinking and in standardized visiting rate,management rate and blood pressure control rate( p > 0. 05). After intervention,the medication compliance rate and salt _ intake control rate and visiting rate,management rate and blood pressure control rate in observation group were higher than those in control group;smoking and drinking rates in observation group were lower than those in control group,all with significant differences (p < 0. 05). And mean monthly medical expenses in observation group were lower than that in control group〔(278 ± 68)vs. (290 ± 63)〕and the difference was statistically significant(p < 0. 05). ConClusion The regional medical association of third_ level hospitals and community health service organizations can improve the validity and continuity of management of hypertensive patients in the community.%目的：评价基于区域医疗联合体的社区高血压患者的健康管理效果。方法于2011年1月从甲社区卫生服务机构的慢性病管理信息系统中，随机抽取原发性高血压病患者600例作为观察组；采用同样的方法，从乙社区卫生服务机构抽取原发性高血压病患者512例作为对照组。对照组患者实施常规诊疗，而观察组在实施常规诊疗的同时运用区域医疗联合体相关机制对其进行管理。研究实施时间为3年，比较两组实施前、后高血压患者规范管理（包括高血压标准化访视率、高血压患者规范管理率、管理人群血压控制率）、患者行为改变（包括遵医用药、控制摄盐量、吸烟、饮酒）及月平均医疗费用情况。结果实施前，两组患者在遵医用药、控制摄盐量、吸烟、饮酒方面差异均无统计学意义（p >0.05）。实施3年后，观察组遵医用药率、控制摄盐率均高于对照组，而吸烟率、饮酒率均低于对照组，差异有统计学意义（p <0.05）。实施前，两组患者在高血压标准化访视、高血压患者规范管理、管理人群血压控制方面差异均无统计学意义（p >0.05）。实施3年后，观察组高血压标准化访视率、高血压患者规范管理率、管理人群血压控制率均高于对照组，差异有统计学意义（p <0.05）。观察组月平均医疗费用低于对照组〔（278±68）元比（290±63）元〕，差异有统计学意义（p <0.05）。结论三级医院与社区卫生服务机构建立区域医疗联合体，可提高社区高血压患者管理的有效性与连续性。
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