School of Public Health, Saint Louis University, St. Louis, Missouri, USA.
J Rural Health. 2010 Winter;26(1):3-11. doi: 10.1111/j.1748-0361.2009.00259.x.
National databases can be used to investigate diabetes prevalence and health care use. Guideline-based care can reduce diabetes complications and morbidity. Yet little is known about the prevalence of diabetes and compliance with diabetes care guidelines among rural residents and whether different national databases provide similar results.
To examine rural-urban differences in the prevalence of diabetes and compliance with guidelines, and to compare the Behavioral Risk Factor Surveillance System (BRFSS) and the Medical Expenditures Panel Survey (MEPS).
Data for 2001-2002 were analyzed and compared by rural-urban status. Prevalence was calculated as simple unadjusted, weighted unadjusted, and weighted adjusted using a multivariate approach. Results from the 2 databases were compared.
A slightly higher prevalence of diabetes among rural residents, 7.9% versus 6.0% in MEPS and 7.6% versus 6.6% in BRFSS, was found and persisted after adjustment for age, BMI, insurance coverage, and other demographic characteristics (adjusted OR 1.16 [1.02-1.31] in MEPS; 1.19 [1.01-1.20] in BRFSS). Rural persons in MEPS were less likely to receive an annual eye examination (aOR = 0.85) and a feet check (aOR = 0.89). A significantly (P < .05) smaller proportion of rural residents in BRFSS received an annual eye examination (aOR = 0.88), feet check (aOR = 0.85), or diabetes education (aOR = 0.83). Rural residents in both datasets were more likely to get a quarterly HbA1c test done.
Rural residents in both datasets had higher prevalence of diabetes. Though not always statistically significant, the trend was to less guideline compliance in rural areas.
国家数据库可用于调查糖尿病的流行情况和医疗保健的使用情况。基于指南的治疗可以减少糖尿病的并发症和发病率。然而，人们对农村居民的糖尿病患病率和遵守糖尿病治疗指南的情况知之甚少，也不知道不同的国家数据库是否提供相似的结果。
研究农村与城市居民在糖尿病患病率和遵守指南方面的差异，并比较行为风险因素监测系统（BRFSS）和医疗支出面板调查（MEPS）。
对 2001-2002 年的数据进行了分析，并按城乡状况进行了比较。采用简单未调整、加权未调整和多元调整方法计算了患病率。比较了两个数据库的结果。
农村居民的糖尿病患病率略高，MEPS 中为 7.9%，BRFSS 中为 7.6%，而 MEPS 中为 6.0%，BRFSS 中为 6.6%，调整年龄、BMI、保险覆盖范围和其他人口统计学特征后仍持续存在（MEPS 中的调整比值比 1.16[1.02-1.31]；BRFSS 中的 1.19[1.01-1.20]）。MEPS 中的农村居民接受年度眼部检查（aOR=0.85）和足部检查（aOR=0.89）的可能性较小。BRFSS 中接受年度眼部检查（aOR=0.88）、足部检查（aOR=0.85）或糖尿病教育（aOR=0.83）的农村居民比例显著较低（P<0.05）。两个数据集的农村居民更有可能每季度进行一次 HbA1c 测试。
两个数据集中的农村居民糖尿病患病率较高。尽管并不总是具有统计学意义，但农村地区的指南遵守情况呈下降趋势。
