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中国大陆基层医疗机构提供的慢性病管理与健康相关生命质量的关系:一项横断面研究。

Association between Health-Related Quality of Life and Access to Chronic Disease Management by Primary Care Facilities in Mainland China: A Cross-Sectional Study.

机构信息

School of Public Health, Peking University, Beijing 100191, China.

China Center for Health Development Studies, Peking University, Beijing 100191, China.

出版信息

Int J Environ Res Public Health. 2023 Feb 28;20(5):4288. doi: 10.3390/ijerph20054288.

DOI:10.3390/ijerph20054288
PMID:36901304
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10001723/
Abstract

The integration of chronic disease management (CDM) services into the essential public health services offered by primary care facilities has been a major strategy in China's healthcare reform since 2009. We aimed to measure the percentage of patients with chronic diseases in China who believed that they could easily obtain CDM services at a nearby primary care facility in mainland China and determine its association with the EQ visual analog scale (EQ-VAS) score and the utility index of the 5-level EQ-5D version (EQ-5D-5L). A cross-sectional survey was conducted nationwide between 20 June 2022 and 31 August 2022, involving 5525 patients with chronic diseases from 32 provincial-level administrative divisions, of which 48.1% ( = 2659) were female with a median age of 55.0 years. The median EQ-VAS score was 73.0 and the utility index of the EQ-5D-5L was 0.942. A majority of patients reported definite (24.3%) or mostly (45.9%) easy access to CDM services from nearby primary care facilities. Multivariable logistic regression analysis revealed that easy access to CDM services in primary care facilities was positively associated with higher HRQoL. Our findings indicate that, as of 2022, approximately 70% of patients with chronic diseases in mainland China had easy access to CDM services provided by primary care facilities, which was significantly and positively associated with their health status.

摘要

慢性病管理(CDM)服务与基层医疗设施提供的基本公共卫生服务相结合,自 2009 年以来一直是中国医疗改革的主要策略。我们旨在衡量中国慢性病患者中认为他们可以轻松在中国大陆附近的基层医疗机构获得 CDM 服务的比例,并确定其与 EQ 视觉模拟量表(EQ-VAS)评分和 EQ-5D 版本的 5 级效用指数(EQ-5D-5L)的关联。2022 年 6 月 20 日至 2022 年 8 月 31 日,在全国范围内进行了一项横断面调查,涉及来自 32 个省级行政区的 5525 名慢性病患者,其中 48.1%(=2659)为女性,中位年龄为 55.0 岁。EQ-VAS 评分的中位数为 73.0,EQ-5D-5L 的效用指数为 0.942。大多数患者报告说,从附近的基层医疗机构获得 CDM 服务非常容易(24.3%)或大部分情况下非常容易(45.9%)。多变量逻辑回归分析显示,基层医疗机构中 CDM 服务的便捷获取与更高的 HRQoL 呈正相关。我们的研究结果表明,截至 2022 年,中国大陆约 70%的慢性病患者可以轻松获得基层医疗机构提供的 CDM 服务,这与他们的健康状况显著且呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a497/10001723/e5e641ceeb58/ijerph-20-04288-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a497/10001723/85f5c0421a43/ijerph-20-04288-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a497/10001723/e5e641ceeb58/ijerph-20-04288-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a497/10001723/85f5c0421a43/ijerph-20-04288-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a497/10001723/e5e641ceeb58/ijerph-20-04288-g002.jpg

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