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中国 2 型糖尿病患者门诊就诊的季节性和月度模式、周内变化及节假日效应。

Seasonal and Monthly Patterns, Weekly Variations, and the Holiday Effect of Outpatient Visits for Type 2 Diabetes Mellitus Patients in China.

机构信息

Center for Health Economics Experiment and Public Policy, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Lixia, District, Jinan 250012, China.

NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China.

出版信息

Int J Environ Res Public Health. 2019 Jul 25;16(15):2653. doi: 10.3390/ijerph16152653.

Abstract

OBJECTIVE

To explore the seasonal and monthly patterns, weekly variations, and the holiday effect of outpatient visits for type 2 diabetes mellitus patients, as well as the influence of gender, age, and insurance type on variations.

METHODS

Data were obtained from the Shandong medical insurance database, including all outpatients in 12 cities of Shandong province in China from 2015 to 2017. The seasonal index () was calculated in terms of seasons, months, and weeks by the moving average method.

RESULTS

A total of 904,488 patients received outpatient services during the study period. The seasonal indices of outpatient visits by type 2 diabetes patients were higher in autumn (108.36%) and spring (102.67%), while lower in winter (89.92%) and summer (99.04%), exhibiting an obvious seasonality. Gender and age had no effect on seasonal patterns. The month impacted the seasons patterns: January to February were the lowest and December the highest months of outpatient visits, complicating the seasonal patterns. We also identified a weekly pattern of outpatient visits. In addition, the outpatient visits for type 2 diabetes mellitus patients was also strongly affected by the Spring Festival, Lantern Festival, and National Day holiday periods. The type of medical insurance had a significant impact on outpatient visits.

CONCLUSIONS

The outpatient visits for type 2 diabetes mellitus patients displayed seasonal patterns that were contradictory to the variations in blood glucose fluctuations found in previous studies and was also strongly affected by the holiday effect. The type of medical insurance impacted the pattern of outpatient visits.

摘要

目的

探讨 2 型糖尿病患者门诊就诊的季节性和月度模式、周内变化以及节假日效应,并分析其性别、年龄和保险类型的影响。

方法

数据来源于山东省医疗保险数据库,包括 2015 年至 2017 年山东省 12 个城市的所有门诊患者。采用移动平均法计算季节、月份和周的季节性指数()。

结果

本研究共纳入 904488 例接受门诊服务的患者。2 型糖尿病患者的门诊就诊季节性指数在秋季(108.36%)和春季(102.67%)较高,而在冬季(89.92%)和夏季(99.04%)较低,表现出明显的季节性。性别和年龄对季节性模式无影响。月份影响季节模式:1 月至 2 月是门诊就诊最低的月份,12 月是最高的月份,使季节性模式复杂化。我们还发现了门诊就诊的周内模式。此外,2 型糖尿病患者的门诊就诊还受到春节、元宵节和国庆节假期的强烈影响。医疗保险类型对门诊就诊有显著影响。

结论

2 型糖尿病患者的门诊就诊呈现季节性模式,与之前研究中发现的血糖波动变化不一致,且受节假日效应的强烈影响。医疗保险类型影响门诊就诊模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19db/6695902/8c73ed5ca769/ijerph-16-02653-g001.jpg

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