【摘要】 目的：基于中断时间序列分析，探讨县域医共体建设对高血压防治效果的影响。方法：以广东省阳西县和阳春市的高血压住院患者为研究对象，采用中断时间序列分析法，比较医共体建设前后住院量、再入院量、平均住院天数和平均住院费用的变化。阳西县作为实验组，自2017年11月起实施紧密型医共体建设，而阳春市作为对照组，于2020年4月开始实施。研究时间窗口为2016年1月至2020年6月，共纳入14294例高血压住院病例。结果：医共体建设对高血压住院量产生了显著影响，阳西县在政策实施后住院量短期内有所下降(β=-36.05,P=0.186),长期有回升趋势(β=11.40,P<0.001)。再入院量和平均住院天数在医共体建设后未显著改善，表明医共体在慢性病复发预防和住院流程优化方面仍需加强。平均住院费用在阳西县短期内有下降趋势(β=-0.168,P=0.026),降幅约为15.5%,但长期趋势显示费用控制效果有限(β=0.010,P=0.070)。结论：医共体建设在控制高血压住院量方面具有一定效果，但在再入院量、平均住院天数和长期费用控制方面的效果不明显。未来医共体建设需进一步优化资源配置，加强上下联动和患者教育随访，以提升慢性病管理的整体效果。更多还原

【Abstract】 Objective To explore the impact of county-level integrated healthcare consortium(IHC) construction on the prevention and treatment of hypertension based on Interrupted Time Series Analysis. Methods 14,294 hospitalization hypertensive cases were included from Yangxi County and Yangchun County, Guangdong Province, in which Yangxi County was taken as the experimental group, implemented a tightly integrated IHC starting from November 2017, while Yangchun County was taken as the control group, implemented from April 2020. Interrupted Time Series Analysis was used to study the changes in hospitalization volume, readmission rates, average duration of stay, and average hospitalization costs for hypertensive patients before and after the implementation of IHC. Results The construction of IHC had a significant impact on hospitalization volume of hypertension. In Yangxi County, hospitalization volume decreased in the short term after policy implementation(β=-36.05,P= 0.186), but showed an increasing trend in the long term(β=11.40,P<0.001). Readmission rates and average duration of stay did not significantly improve after the IHC construction, indicating that further efforts are needed in preventing chronic disease recurrence and optimizing hospitalization processes. Average hospitalization costs showed a short-term decreasing trend(β=-0.168,P=0.026), with a reduction of approximately 15.5%, but the long-term trend indicated limited cost control effectiveness(β=0.010,P=0.070). Conclusion The construction of IHC demonstrated some effectiveness in controlling hypertension hospitalization volume, but its impact on readmission rates, average duration of stay, and long-term cost control was not significant. Future IHC development should focus on optimizing resource allocation, strengthening multi-level collaboration, and enhancing patient education and follow-up to improve the overall effectiveness of chronic disease management.更多还原