全科医生团队签约服务模式在社区2型糖尿病患者管理中的效果评价

Effect of signing contracted with general practitioner team on management of type 2 diabetes mellitus

目的调查全科医生团队签约模式服务对社区2型糖尿病患者糖尿病相关知识知晓率、患者依从性和血糖控制率的影响。方法 463例糖尿病患者按是否接受全科医生团队签约服务的管理分为签约组和未签约组,签约组按照年龄分为中青年组和老年组,比较两组及两亚组患者的糖尿病相关知识知晓率、患者依从性,并统计血糖控制率。结果签约组和未签约组的糖尿病相关知识知晓率(糖尿病诊断标准知晓率、血糖控制目标知晓率、急慢性并发症知晓率、饮食控制原则知晓率)比较,差异均有统计学意义(χ2分别=5.17、5.34、5.64、4.76,P均<0.05),而两组肥胖诊断标准知晓率比较,差异无统计学意义(χ2=1.87,P>0.05)。两组患者依从性方面(按照医嘱服药、自行停药、定时检测血糖)比较,差异均有统计学差异(χ2分别=7.52、4.97、4.23,P均<0.05)。两组血糖控制率比较,差异亦有统计学意义(χ2=7.26,P<0.05)。两亚组糖尿病知识知晓率(糖尿病诊断标准知晓率、糖控制目标知晓率、糖尿病急慢性并发症知晓率、肥胖诊断标准知晓率)比较,差异有统计学意义(χ2分别=5.78、4.59、9.64、4.97,P均<0.05),而且饮食控制原则知晓率比较,差异无统计学意义(χ2=0.41,P>0.05)。两亚组患者依从性(按医嘱服药、自行停药、定时监测血糖)比较,差异均无统计学意义(χ2分别=0.69、2.61、1.44,P均>0.05)。两亚组血糖控制率比较,差异亦无统计学意义(χ2=1.64,P>0.05)。结论全科医师团队签约服务模式能够有效提高糖尿病患者尤其是老年患者的糖尿病相关知识知晓率、依从性和血糖控制率。

Objective To explore the influence of signing contracted with general practitioner team on diabetes knowledge awareness rate,patient compliance and blood glucose control rate in type 2 diabetes mellitus. Methods A total of 463 cases of diabetes were collected and divided into the contract group and the non-contract group according to whether received signing contracted with general practitioner team. And the cases in contract group were divided into two subgroups： the young and middle-aged group and the elderly group. Diabetes knowledge awareness rate,patient compliance and blood glucose control rate were compared. Results The difference of diabetes knowledge awareness rate（awareness rate of diabetes diagnostic criteria,target awareness rate of blood glucose control,awareness rate of acute and chronic complications,awareness rate of diet control principle） between the contract group and the non-contract group were statistically significant （χ2=5.17, 5.34,5.64,4.76,P〈0.05）,While there was no statistical difference of awareness rate of diagnostic criteria for obesity （χ2=1.87,P〉0.05）. The difference of patient compliance （take medication according to medical advice, stop taking the drugs without medical advice,timed detection of blood glucose） between the contract group and the non-contract group were statistically significant （χ2=7.52,4.97,4.23,P〈0.05）. Meanwhile,the difference of blood glucose control rate between two groups was also statistically significant （χ2=7.26,P〈0.05）. The difference of diabetes knowledge awareness rate （awareness rate of diabetes diagnostic criteria,target awareness rate of blood glucose control,awareness rate of acute and chronic complications,awareness rate of diagnostic criteria for obesity） between the middle-aged group and the elderly group were statistically significant （χ2=5.78,4.59,9.64,4.97,P〈0.05）. But the difference of awareness rate of diet control principle was not statistically significant （χ2=0.41,P〉0.05）. The difference of patient compliance （take medication according to medical advice,stop taking the drugs without medical advice , timed detection of blood glucose ） between two subgroups was not statistically significant （χ2=0 . 69,2.61,1.44,P〉0.05）. Meanwhile,the difference of blood glucose control rate was also not statistically significant （χ2=1.64,P〉0.05）. Conclusion Signing contract with general practitioner team improve the diabetes knowledge awareness rate,patient compliance and blood glucose control rate of the diabetes patients.