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柬埔寨初级卫生保健中糖尿病综合护理实施程度的深入分析

An in-depth Analysis of the Degree of Implementation of Integrated Care for Diabetes in Primary Health Care in Cambodia.

作者信息

Te Vannarath, Long Sereyraksmey, Van Damme Wim, Ir Por, Wouters Edwin, van Olmen Josefien

机构信息

School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia.

Health Policy Unit, Department of Public Health, Institute of Tropical Medicine (Antwerp), Belgium.

出版信息

Int J Integr Care. 2024 Dec 4;24(4):11. doi: 10.5334/ijic.7602. eCollection 2024 Oct-Dec.

Abstract

INTRODUCTION

With the rising prevalence of type 2 diabetes (T2D), three care initiatives for T2D are being scaled-up in Cambodia to improve availability and accessibility of integrated care for T2D: (1) , (2) , and (3) . This case study aims to share learnings from an in-depth analysis of the level of integrated care implementation in these care initiatives for T2D in Cambodia.

DESCRIPTION

Twenty public health facilities in five operational districts were assessed on six integrated care components: (1) early detection and diagnosis, (2) treatment in primary care services, (3) health education, (4) self-management support, (5) structured collaboration, and (6) organisation of care. Two raters independently scored each facility on a 0-5 scale based on multiple sources of data and reached a consensus.

DISCUSSION

The in-depth analysis showed that the three care initiatives were not implemented in an integrated manner, with low implementation scores (1 or 2 out of 5) in all selected settings. The presence of was associated with higher scores for early detection and diagnosis and treatment in primary care services, while the presence of was related to structured collaboration and organisation of care.

CONCLUSION

The evidence suggests that while each care initiative has its potential contributions towards integrated care for T2D, the three care initiatives should be effectively implemented in an integrated manner in order to potentially produce the desired outcomes.

摘要

引言

随着2型糖尿病(T2D)患病率的上升,柬埔寨正在扩大三项T2D护理举措,以提高T2D综合护理的可及性和可获得性:(1) ,(2) ,以及(3) 。本案例研究旨在分享对柬埔寨这些T2D护理举措中综合护理实施水平进行深入分析所获得的经验教训。

描述

对五个运营区的20家公共卫生机构在六个综合护理组成部分方面进行了评估:(1)早期检测与诊断,(2)初级护理服务中的治疗,(3)健康教育,(4)自我管理支持,(5)结构化协作,以及(6)护理组织。两名评估者根据多种数据来源,以0至5分的尺度对每个机构独立评分,并达成共识。

讨论

深入分析表明,这三项护理举措并未以综合方式实施,在所有选定机构中的实施得分较低(5分制中为1分或2分)。 的存在与初级护理服务中早期检测与诊断以及治疗的较高得分相关,而 的存在与结构化协作和护理组织有关。

结论

证据表明,虽然每项护理举措对T2D综合护理都有其潜在贡献,但这三项护理举措应以综合方式有效实施,以便有可能产生预期结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae23/11623098/5557dc7a85df/ijic-24-4-7602-g1.jpg

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