Department of Health Services Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Public Health. 2021 Aug 24;21(1):1588. doi: 10.1186/s12889-021-11639-2.
Diabetes mellitus is a complex chronic disease requiring appropriate continuous medical care and delayed, or forgone care may exacerbate the severity of the disease. This study aimed to investigate the factors affecting forgone care in patients with type2 diabetes.
This was a cross-sectional study involving 1139 patients with type 2 diabetes aged> 18 years in 2019 in Tabriz, Iran. The researcher-made questionnaire was used for data collection. Data were analyzed using IBM SPSS software version 22 and IBM AMOS 22. Exploratory Factor Analysis (EFA) was performed for dimension reduction of the questionnaire, and Confirmatory Factor Analysis (CFA) used to verify the result of EFA. We applied the binary logistic regression model to assess the factors affecting forgone care.
Of the 1139 patients, 510 patients (45%) reported forgone care during the last year. The percentage of forgoing care was higher in patients without supplementary insurance coverage (P = 0.01), those with complications (P = 0.01) and those with a history of hospitalization (P = 0.006). The majority of patients (41.5%) reported that the most important reason for forgoing care is financial barriers resulting from disease treatment costs. Of the main four factors affecting, quality of care had the highest impact on forgone care at 61.28 (of 100), followed by accessibility (37.01 of 100), awareness and attitude towards disease (18.52 of 100) and social support (17.22 of 100).
The results showed that, despite the implementation of the Islamic Republic of Iran on a fast-track to beating non-communicable diseases (IraPEN), a considerable number of patients with type2 diabetes had a history of forgoing care, and the most important reasons for forgoing care were related to the financial pressure and dissatisfaction with the quality of care. Therefore, not only more financial support programs should be carried out, but the quality of care should be improved.
糖尿病是一种复杂的慢性疾病，需要进行适当的持续医疗护理，否则护理的延迟或缺失可能会使病情恶化。本研究旨在探讨影响 2 型糖尿病患者放弃护理的因素。
这是一项 2019 年在伊朗大不里士对 1139 名年龄>18 岁的 2 型糖尿病患者进行的横断面研究。研究人员使用自制问卷收集数据。使用 IBM SPSS 软件版本 22 和 IBM AMOS 22 分析数据。采用探索性因子分析（EFA）对问卷进行降维，采用验证性因子分析（CFA）验证 EFA 的结果。我们应用二元逻辑回归模型评估影响放弃护理的因素。
在 1139 名患者中，有 510 名（45%）患者在过去一年中放弃了护理。无补充保险覆盖的患者（P=0.01）、有并发症的患者（P=0.01）和有住院史的患者（P=0.006）放弃护理的比例更高。大多数患者（41.5%）报告放弃护理的最重要原因是疾病治疗费用导致的经济障碍。在影响放弃护理的四个主要因素中，医疗质量的影响最大，为 61.28（满分 100），其次是可及性（满分 100 的 37.01）、对疾病的认识和态度（满分 100 的 18.52）和社会支持（满分 100 的 17.22）。
结果表明，尽管伊朗伊斯兰共和国在实现非传染性疾病快速通道（IraPEN）方面取得了进展，但仍有相当数量的 2 型糖尿病患者有放弃护理的历史，放弃护理的最重要原因与经济压力和对护理质量的不满有关。因此，不仅应开展更多的财政支持计划，还应提高医疗质量。
