糖尿病相关可避免住院治疗及其与中国基层医疗资源的关系:来自四川省的一项横断面研究。
Diabetes-related avoidable hospitalisations and its relationship with primary healthcare resourcing in China: A cross-sectional study from Sichuan Province.
机构信息
HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China.
出版信息
Health Soc Care Community. 2022 Jul;30(4):e1143-e1156. doi: 10.1111/hsc.13522. Epub 2021 Jul 26.
The reduction of diabetes-related avoidable hospitalisations (AHs) can be achieved via the provision of timely and effective primary healthcare (PHC), which has made diabetes AHs rate a widely adopted indicator for evaluating the performances of PHC systems. This study reported the AHs rate of diabetes and further explored its relationship with PHC resourcing in China. Hospital discharge data of the fourth quarters of 2016 and 2017 in Sichuan Province, China were used. The number of PHC doctors per 10,000 population and the proportion of PHC doctors on all doctors were used as indicators reflective of PHC resourcing. Linear regression models were used to explore the associations between PHC resourcing and AHs of diabetes. Age-standardised rates of diabetes-related AHs in Sichuan province, China were found to be 248.102 and 272.368 per 100,000 population in 2016 and 2017, respectively. A 10% increase in the number of PHC doctors per 10,000 population was associated with a reduction of 2.574 per 100,000 population in the age-standardised AHs rate of diabetes. In addition, 10% increase in the proportion of PHC doctors on all doctors was associated with a reduction of 10.839 diabetes-related AHs per 100,000 population. Based on subgroup analysis, PHC resourcing demonstrated to have a stronger impact on AHs of diabetes with long-term complications than on that of uncontrolled diabetes. Our findings reported that the diabetes AHs rates in Sichuan Province were prevalently high. We also found that increased PHC resourcing was associated with decreased diabetes-related AHs rates.
糖尿病相关可避免住院(AHs)的减少可以通过及时有效的初级医疗保健(PHC)来实现,这使得糖尿病 AHs 率成为评估 PHC 系统绩效的广泛采用的指标。本研究报告了糖尿病的 AHs 率,并进一步探讨了其与中国 PHC 资源的关系。使用了中国四川省 2016 年和 2017 年第四季度的医院出院数据。每 10,000 人口的 PHC 医生人数和 PHC 医生占所有医生的比例被用作反映 PHC 资源的指标。使用线性回归模型探讨了 PHC 资源与糖尿病 AHs 之间的关联。发现中国四川省糖尿病相关 AHs 的年龄标准化率在 2016 年和 2017 年分别为每 100,000 人口 248.102 和 272.368。每 10,000 人口的 PHC 医生人数增加 10%,与糖尿病的年龄标准化 AHs 率降低 2.574 相关。此外,所有医生中 PHC 医生比例增加 10%,与每 100,000 人口中与糖尿病相关的 AHs 减少 10.839 相关。基于亚组分析,PHC 资源对伴有长期并发症的糖尿病 AHs 的影响大于对未控制的糖尿病 AHs 的影响。我们的研究结果报告称,四川省的糖尿病 AHs 率普遍较高。我们还发现,增加 PHC 资源与降低糖尿病相关 AHs 率有关。