Feng Da, Serrano Ray, Ye Ting, Tang Shangfeng, Duan Lei, Xu Yuan, Yang Jian, Liang Yuan, Chen Shanquan, Feng Zhanchun, Zhang Liang
School of Medicine and Health Management, Tongji Medical College, Hua Zhong University of Science and Technology, No.13 of Hangkong Road, Qiaokou District, Wuhan 430030, China.
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Int J Environ Res Public Health. 2016 Dec 21;13(12):1268. doi: 10.3390/ijerph13121268.
Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in 2015 on diabetic and hypertensive patients in Hubei Province. We used binary logistic regression models to determine specific factors associated with diabetic and hypertensive patients that sought healthcare services for their conditions in accordance with current Chinese Centers for Disease Prevention and Control (CDC) guidelines. Our findings show that 42.16% of 510 people living with chronic conditions (PLCDs) sought health services in line with existing guidelines. Findings also show a higher probability (8.418 times) for PLCDs seeking healthcare services at higher-tiered hospitals (secondary and tertiary hospitals) than for PLCDs seeking care at primary hospitals (odds ratio (OR) = 8.418, 95% confidence interval (CI) = 4.82, 14.27, < 0.001). These analyses underscore the importance of having patient advocates who can provide support, where necessary, and encourage positive health-seeking behavior. The study also shows a negative impact on regular maintenance for PLCDs in households with high financial constraints. In contrast, the study shows positive impacts for increased household income, age, and residency in rural locations. In sum, this study underscores the importance of primary hospitals as key points of care and critical players in care coordination for PLCDs. The study provides more evidence for Chinese policymakers seeking to contain costs and improve population health. The findings also underscore the need for community-based interventions, specifically interventions that link local primary hospitals, friends/family members, and PLCDs.
非传染性慢性病的定期管理可以抑制糖尿病和高血压患者的疾病进展。为了确定与积极的健康寻求行为及慢性病定期管理相关的个人和社会因素，我们于2015年对湖北省的糖尿病和高血压患者进行了一项随访研究。我们使用二元逻辑回归模型来确定与糖尿病和高血压患者相关的特定因素，这些患者根据中国疾病预防控制中心（CDC）目前的指南为其病情寻求医疗服务。我们的研究结果显示，在510名慢性病患者中，42.16%的人按照现有指南寻求了医疗服务。研究结果还表明，与在基层医院寻求治疗的慢性病患者相比，慢性病患者在上级医院（二级和三级医院）寻求医疗服务的可能性更高（8.418倍）（优势比（OR）=8.418，95%置信区间（CI）=4.82，14.27，<0.001）。这些分析强调了有患者支持者的重要性，他们可以在必要时提供支持，并鼓励积极的健康寻求行为。该研究还表明，经济高度紧张的家庭中的慢性病患者进行定期管理会受到负面影响。相比之下，该研究表明家庭收入增加、年龄增长和居住在农村地区会产生积极影响。总之，本研究强调了基层医院作为慢性病患者护理协调的关键点和关键参与者的重要性。该研究为寻求控制成本和改善人群健康的中国政策制定者提供了更多证据。研究结果还强调了基于社区的干预措施的必要性，特别是将当地基层医院、朋友/家庭成员和慢性病患者联系起来的干预措施。
