老年糖尿病足患者诊疗服务利用及经济负担的定性研究

Qualitative analysis on the utilization of health services and economic burden of the elderly patients with diabetic foot ulcer

目的:了解老年糖尿病足患者的就医行为、服务利用和经济负担情况,为改善老年糖尿病足的防治效果提供政策建议。方法:采用目的抽样,获得知情同意后对南京军区联勤部解放军第四五四医院2013年12月—2014年1月住院治疗的15例老年糖尿病足患者进行个人深入访谈。结果:老年糖尿病足患者具有较高的卫生服务需求,重"治"轻"防";服务利用和效果受经济水平、医疗保障制度、社区服务提供能力等诸多因素影响。结论:为提高老年糖尿病足患者的治疗效果和生命质量,应加强患者的健康教育,以社区为基础建立一体化的疾病管理与服务体系,制定减轻患者疾病经济负担的政策。

Objective： To explore the health seeking behavior,utilization of health services and the economic burden of the elderly patients with diabetic foot ulcer（ DF）,with aim to provide policy evidence for improving their DF prevention and treatment outcomes. Methods： The purposive sampling method was applied to recruit 15 elderly DF patients treated in the 454 th Hospital of Chinese PLA from December 2013 to January 2014. After informed consent,they were in-depth interviewed. Results： The elderly with DF had a higher demand for the health services.They emphasized on treatment and neglected prevention. The utilization and efficiency of health services were affected by patients＇ economic level,medical insurance,capacity of community services,and so on. Conclusion： In order to improve the treatment outcome and quality of life for the elderly DF patients,it＇s necessary to strengthen patients＇ health education,to build a community-based and integrated health care system on DF prevention,treatment and management,and to develop the policies for reducing DF related economic burden.