数字健康背景下糖尿病基层医防融合服务的需求研究

Demand Analysis of Diabetes Primary Healthcare and Prevention Integration Services in the Context of Digital Health

背景随着人口老龄化进程加快,居民疾病谱变化,以糖尿病为代表的慢性病患病率逐年攀升,亟须建立广覆盖、高效率的基层医防融合模式。已有研究多聚焦于健康管理服务需求及服务采纳的影响因素,鲜有对数字技术下慢性病医防融合服务需求进行识别与分析的研究。目的探索数字健康背景下居民对糖尿病医防融合服务需求,以及不同服务内容对服务对象接受度与满意度的影响,以期为完善全过程、全方位的医防融合服务提供理论依据。方法结合相关研究与实际工作,确立了20项糖尿病医防融合服务需求调查项目,并于2023年1—6月,采用便利抽样法调查福建省、广东省和云南省的糖尿病患病及风险人群,获取410名受访者数据,收集性别、年龄、文化程度、居住地类型和医保类型五类人口学特征,依据Kano模型分析法进行属性分类分析,考察不同属性的服务需求与居民满意度的关系,进而提出糖尿病医防融合服务供给策略。结果不同人口学特征的居民对糖尿病医防融合服务需求显示出共性和个性差异,其中,不同年龄段和文化程度的人群服务需求差异较大。糖尿病防治群体的医防融合服务需求聚焦在筛防和诊疗环节,但互联网与社交媒体提供的相关便捷服务与用户的满意度无关。结论应当提升糖尿病基层医防融合服务个性化水平,充分满足服务人群的“糖尿病与并发症初步筛查”等必备属性需求,完善“建立全周期个人电子健康档案”等期望属性服务,以及提升“风险预测”“远程健康监测”等魅力属性需求的服务。

Background With the acceleration of the aging process of the population and the change of the disease spectrum of residents,the prevalence of chronic diseases such as diabetes is increasing year by year.It is urgent to establish a wide coverage and efficient medical prevention integration mode.Most of the existing studies have focused on the demand for health management services and the influencing factors of service adoption,and few have identified and analyzed the demand for chronic disease healthcare and prevention integration services under digital technology.Objective To explore the demand of residents for medical and preventive integration services for diabetes in the context of digital health,and the impact of different service contents on the acceptance and satisfaction of service objects,so as to provide a theoretical basis for the public to improve the whole process and all-round medical and preventive integration services.Methods Combined with relevant research and practical work,20 survey items on demand for diabetes medical and prevention integration services were established.From January to June 2023,convenient sampling method was used to survey diabetes patients and risk groups in Fujian Province,Guangdong Province and Yunnan Province,and 410 respondents'data were obtained.According to five demographic characteristics of gender,age,education level,residence type and medical insurance type,attribute classification analysis was carried out according to Kano model analysis method,to investigate the relationship between service demand of different attributes and residents'satisfaction,and then put forward the supply strategy of diabetes medical and prevention integration services.Results Residents with different demographic characteristics show common and individual differences in the demand for medical and preventive integration services for diabetes.Among them,the demand for services among people of different ages and educational levels is quite different.The demand for medical prevention integration services of diabetes prevention and treatment groups focuses on screening,prevention and treatment,but the relevant convenient services provided by the Internet and social media have nothing to do with user satisfaction.Conclusion The level of personalization of diabetes primary health care and prevention services should be improved to fully satisfy the needs of the service population for essential attributes such as"initial screening for diabetes and complications",improve the services for desired attributes such as"establishment of a full-cycle personal electronic health record",and enhance the services for charismatic attributes such as"risk prediction"and"remote health monitoring".It will also improve services with desired attributes such as the establishment of a full-cycle personal electronic health record,and enhance services with attractive attributes such as"risk prediction"and"remote health monitoring".