2018年辽宁省基层医疗机构2型糖尿病患者健康管理服务调查分析

Analysis of the situation of health management services for type 2 diabetes patients provided by primary medical institutions,Liaoning,2018

目的2009年国家实施基本公共卫生服务项目,要求基层医疗机构为2型糖尿病患者提供健康管理服务。本研究调查辽宁省服务现状,为辽宁省规范健康管理糖尿病患者提供科学依据。方法采用横断面调查方法,对辽宁省7个市的9252例≥35岁的在管患者进行随访信息回顾,分析年龄及可支配收入等因素对患者糖尿病控制率的影响。结果9252例在管患者中,总体血糖控制率为50.88%,城市居民血糖控制率为49.28%,乡镇居民血糖控制率为53.79%,差异有统计学意义,χ2=17.191,P<0.001。血糖控制率与年龄呈反比,年龄越大血糖控制率越低,差异有统计学意义,χ2=38.921,P<0.001。体质量指数(body mass index,BMI)高的患者血糖控制率低,χ2=113.033,P<0.001。高收入地区血糖控制率为43.59%,中收入地区为34.68%,低收入地区为68.89%,差异有统计学意义,χ2=404.164,P<0.001。服用消渴丸的患者血糖控制率最高,为55.30%,收入越低服用消渴丸的比例越高。结论辽宁省基层医疗机构健康管理2型糖尿病患者血糖控制率与年龄等危险因素相关,提高综合管理服务质量可以提升血糖控制率。

OBJECTIVE In 2009,China implemented the basic public health service program and asked the basic medical institution to provide health management service for type 2 diabetic patients.This survey studied the present situation of service in Liaoning Province,and provided scientific basis for the standardization of health management for diabetics in Liaoning province.METHODS A cross-sectional survey method was used to review the follow-up information of 9252 in-patients≥35 years old in 7 cities in Liaoning Province,and analyzed the influence of age,disposable income and other factors on the diabetes control rate of patients.RESULTS The control rates of blood glucose of diabetic patients,urban residents,and township residents were 50.88%,49.28%and 53.79%(χ~2=17.191,P<0.001).The blood glucose control rate was inversely proportional to age.The older the age,the lower the blood glucose control rate,and the difference was statistically significant(χ~2=38.921,P<0.001).Patients with high body mass index(BMI)had low glycemic control rate.The glycemic control rates in high-income areas,middle-income areas and low-income areas were 43.59%,34.68%and 68.89%.The difference was statistically significant(χ~2=404.164,P<0.001).Patients taking Xiaoke pills had the highest blood sugar control rate of 55.30%,the lower the income,the higher the proportion of taking Xiaoke pills.CONCLUSIONS The blood glucose control rate of type 2 diabetes patients in health management of primary medical institutions in our province is related to age and other risk factors.Improving the quality of comprehensive management service can improve the blood glucose control rate.