Montana Department of Public Health and Human Services, Chronic Disease Prevention and Health Promotion Bureau, Helena, Montana, USA.
J Public Health Manag Pract. 2011 May-Jun;17(3):242-7. doi: 10.1097/PHH.0b013e3181f9eec5.
The purpose of this study was to assess the capacity of diabetes self-management education (DSME) programs in urban and rural counties to provide services to patients with diagnosed diabetes, lifestyle services to persons at high risk for developing diabetes, and to assess the potential barriers to providing diabetes prevention services.
In 2009, the Montana Department of Public Health and Human Services conducted an Internet-based survey of all DSME programs in Montana.
Thirty of the 39 (77%) DSME programs completed the survey. Seventy-seven percent of the urban programs and 50% of the rural programs reported a capacity to provide DSME to additional patients with diagnosed diabetes. More than 70% of the urban and the rural programs currently provide lifestyle services to patients with abnormal glucose tolerance but without diabetes. Eighty-four percent of the urban programs and 60% of the rural programs reported a capacity to provide lifestyle services to additional persons at high risk for diabetes. Eighty-five percent of the urban programs and 58% of the rural programs have already implemented or intend to implement a lifestyle intervention service consistent with the Diabetes Prevention Program. Overall, the most frequently reported barriers to implementing a diabetes prevention services were lack of reimbursement (80%) and the lack of staff to provide the service (60%).
Urban and rural DSME programs in Montana have the capacity to implement both DSME for patients with diagnosed diabetes and diabetes prevention lifestyle services to additional people at high risk for diabetes. Reimbursement for diabetes prevention services is critical to ensure program development and implementation.
本研究旨在评估城乡县级糖尿病自我管理教育(DSME)计划为已确诊糖尿病患者提供服务、为有发展为糖尿病风险的人提供生活方式服务的能力,并评估提供糖尿病预防服务的潜在障碍。
2009 年,蒙大拿州公共卫生和人类服务部对蒙大拿州所有 DSME 计划进行了基于互联网的调查。
39 个 DSME 计划中有 30 个完成了调查。77%的城市项目和 50%的农村项目报告称有能力为更多已确诊糖尿病患者提供 DSME。超过 70%的城市和农村项目目前为葡萄糖耐量异常但无糖尿病的患者提供生活方式服务。84%的城市项目和 60%的农村项目报告称有能力为更多有糖尿病高风险的人提供生活方式服务。85%的城市项目和 58%的农村项目已经实施或打算实施与糖尿病预防计划一致的生活方式干预服务。总体而言,实施糖尿病预防服务的最常报告障碍是缺乏报销(80%)和缺乏提供服务的人员(60%)。
蒙大拿州城乡 DSME 计划有能力为已确诊糖尿病患者实施 DSME 和为更多有糖尿病高风险的人提供糖尿病预防生活方式服务。糖尿病预防服务的报销对于确保项目的开发和实施至关重要。