Miao Yudong, Ye Ting, Qian Dongfu, Li Jinlong, Zhang Liang
1. School of Health Policy and Management, Nanjing Medical University , Nanjing, China.
2. School of Medicine and Health Management of Tongji Medical College of Huazpong University of Science and Technology , Wuhan, China.
Iran J Public Health. 2014 Jun;43(6):769-77.
Primary care physicians' visit services for diabetes management are now widely delivered in China's rural public health care. Current studies mainly focus on supply but risk factors from patients' view have not been previously explored. This study aims to present the utilization of rural primary care physicians' visit services for diabetes management in the last 12 months in southwestern China, and to explore risk factors from patients' view.
This cross sectional study selected six towns at random and all 385 diabetics managed by primary care physicians were potential participants. Basing on the inclusion and exclusion criteria, 374 diabetics were taken as valid subjects and their survey responses formed the data resource of analyses. Descriptive indicators, χ2 contingency table analyses and Logistic regression were used.
54.8% respondents reported the utilization of visit services. According to the multivariate analysis, the positive factors mainly associated with utilization of visit services include disease duration (OR=1.654), use of diabetic drugs (OR=1.869), consulting diabetes care knowledge (OR=1.602), recognition of diabetic complications (OR=1.662), needs of visit services (OR=2.338).
The utilization of rural primary care physicians' visit services still remains unsatisfactory. Mass rural health policy awareness, support, and emphasis are in urgent need and possible risk factors including disease duration, use of diabetic drugs, consulting diabetes care knowledge, recognition of diabetic complications and needs of visit services should be taken into account when making rural health policy of visit services for diabetes management in China and many other low- and middle-income countries.
在中国农村公共卫生保健中,基层医疗医生提供的糖尿病管理诊疗服务目前已广泛开展。当前研究主要聚焦于服务供给,但患者视角的风险因素此前尚未得到探讨。本研究旨在呈现中国西南部农村地区基层医疗医生在过去12个月中提供的糖尿病管理诊疗服务的利用情况,并从患者视角探索风险因素。
本横断面研究随机选取了6个乡镇,所有由基层医疗医生管理的385名糖尿病患者均为潜在参与者。根据纳入和排除标准,374名糖尿病患者被作为有效研究对象,他们的调查回复构成了分析的数据来源。采用描述性指标、χ2列联表分析和Logistic回归分析。
54.8%的受访者报告使用了诊疗服务。多因素分析显示,与诊疗服务利用相关的积极因素主要包括病程(OR = 1.654)、使用降糖药物(OR = 1.869)、咨询糖尿病护理知识(OR = 1.602)、认识糖尿病并发症(OR = 1.662)、对诊疗服务的需求(OR = 2.338)。
农村基层医疗医生诊疗服务的利用率仍不尽人意。急需提高农村地区对卫生政策的认识、支持力度并加强重视。在中国以及许多其他低收入和中等收入国家制定农村糖尿病管理诊疗服务卫生政策时,应考虑包括病程、降糖药物使用、咨询糖尿病护理知识、认识糖尿病并发症以及对诊疗服务的需求等可能的风险因素。