Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an 710127, China.
School of Economics and Finance, Xi'an Jiaotong University, Xi'an 710061, China.
Int J Environ Res Public Health. 2020 Dec 12;17(24):9297. doi: 10.3390/ijerph17249297.
Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.
慢性病可以通过有效的自我管理来控制。本研究旨在探讨中国西南部农村地区高血压或糖尿病患者（PWHD）的临床就诊和用药依从性的规律及其与首次护理体验和个体因素的关系。这项横断面研究于 2018 年在云南省进行，在 10 个县的 122 个村中招募了 292 名 PWHD 和 122 个村诊所。参与者使用结构化问卷进行访谈。结果显示，约 39%的高血压患者和 25%的糖尿病患者在访谈日期前的三个月内既没有看医生也没有规律服药。回归结果进一步表明，PWHD 的个体特征，包括患者年龄、健康状况和经济水平，以及他们的首次护理体验，与他们的定期医疗保健行为显著相关。除了提供医疗服务外，每个样本村诊所平均有大约两名医生，同时管理 180 名高血压患者和 45 名糖尿病患者。这项研究揭示了需要进一步改革自我管理，因此建议增加中国农村初级保健领域的人力资源数量和质量。
