循環器疾患対策事業の評価に関する研究―大豊町における6年間の資料解析を通して

Evaluation for Countermeasure Services for Cirulatory Diseases

要旨

　高知県大豊町において，6年間にわたり実施してきた循環器対策事業について，1．受診率の上昇(ハイリスク者の発見)，2．ハイリスク者の減少，3．脳卒中発症者の減少と経過の改善の3つの視点からその効果を検討することを目的とした．

　昭和53年から58年までの6年間の循環器検診受診票，家庭訪問記録および関連資料を用い集計，解析した．

　受診率の上昇及び継続受診者の増加によってハイリスク者の発見率が高まった．ハイリスク者の中でも特に高度高血圧者の減少は顕著で6年間に半減した．また，6年間を前期と後期に分け比較すると40～69歳で有意に減少した．脳卒中発症は数・率共に減少し，昭和58年には30～59歳で発症は0となった．また，脳出血，脳梗塞を比較すると前者の減少傾向が大きく認められた．循環器対策事業の評価についてハイリスク者を対象とし，対象自体の推移と最終目標である脳卒中予防を関連してみることにより効果を判定した．

Abstract

　The purpose of this research is to evaluate the effect for countermeasure services for circulatory diseases, carried out for the past six years in Taiho-cho, Kochi Prefecture, from the following three aspects:1. to identify high-risk people, 2. to reduce the number of high-risk people, 3. to decrease the number of cerebral apoplexy patients and to improve the care during the rehabilitation process.

　Available materials from 1978 to 1983, which are related to countermeasure services for circulatory diseases were analyzed.

　The ratio of identified high-risk peopple was raised by a rise of number of people received the medical treatment and the follow-up care. Especially, hypertensive persons were remarkably reduced by half for the past six years. As compared the first term with the latter term of countermeasure services, the hypertensive persons among the age of 40 to 69 were significantly decreased. This demonstrates that the countermeasure services were spread throughout the community and their effect was highly evaluated.

　The both the number and ratio of cerebral apoplexy patients were reduced, and no stroke person among the age of 30 to 59 was found in 1983. In comparison of cerebral hemorrhage with cerebral infarct, it was found that the former tended to be decreased.

　In regard to the evaluation for countermeasure services for cirulatory diseases, it seems that the effect for the services can be judged in reference to a shift of subject and prevention of cerebral apoplexy.