医疗联合体对社区糖尿病患者病情控制和费用影响的效果分析

Analysis of Effectiveness with Medical Complex on Community Diabetes Control and Cost of Illness

目的:探讨医疗联合体建设管理对社区糖尿病患者病情控制和费用影响的效果。方法:选择白岩社区卫生服务中心2014年登记在册的107例2型糖尿病医保患者作为规范组,纳入医疗联合体,实施糖尿病规范管理,同时选择登记在册的107例2型糖尿病医保患者为普通组,采用常规指导和治疗。比较两组患者干预1年糖尿病的病情控制,医疗费用情况。结果:规范组患者空腹血糖、餐后2 h血糖、糖化血红蛋白、收缩压、甘油三酯均低于普通组,差异均有统计学意义(t=2.346、2.763、2.759、5.004、2.104,P<0.05),规范组患者的舒张压、总胆固醇与普通组比较,差异均无统计学意义(t=1.899、1.782,P>0.05)。结论:二级医院与社区卫生服务中心建立医疗联合体的模式,对糖尿病患者病情控制效果良好,并可提高患者的自我管理能力及对糖尿病的认知力,减少医疗费用,从而减轻社会和家庭的负担。

Objective：To explore the effect of medical consortium construction management on the control and cost of community diabetes patients.Method：A total of 107 patients with type 2 diabetes mellitus who enrolled in 2014 in Baiyan Community Health Service Center were selected as the normative group and included in the medical association to administer diabetes norms,and 107 registered type 2 diabetes mellitus patients as the normal group received general guidance and treatment at the same time.The two groups of patients with diabetes control of the disease,the medical costs were compared.Result：The fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,systolic blood pressure and triglyceride in the normative group were all lower than those in the normal group,the differences were statistically significant（t=2.346,2.763,2.759,5.004,2.104,P〈0.05）,and there were no significant difference in diastolic pressure and total cholesterol in the two groups（t=1.899,1.782,P〉0.05）.Conclusion：The model of establishing medical association between secondary hospital and community health service center has a good effect on the control of patients with diabetes and can improve patients＇ ability of selfmanagement and cognition of diabetes,reduce medical costs and reduce social and family burden.