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吴韶嫣, 戴悦, 李跃平. 三明市农村糖尿病患者医疗服务人际连续性特征及其影响因素分析[J]. 中国公共卫生, 2022, 38(1): 99-104. DOI: 10.11847/zgggws1131796new
引用本文: 吴韶嫣, 戴悦, 李跃平. 三明市农村糖尿病患者医疗服务人际连续性特征及其影响因素分析[J]. 中国公共卫生, 2022, 38(1): 99-104. DOI: 10.11847/zgggws1131796new
WU Shao-yan, DAI Yue, LI Yue-ping. Continuity of health care for rural diabetic patients and its associates in Sanming city: an interpersonal relationship-based analysis[J]. Chinese Journal of Public Health, 2022, 38(1): 99-104. DOI: 10.11847/zgggws1131796new
Citation: WU Shao-yan, DAI Yue, LI Yue-ping. Continuity of health care for rural diabetic patients and its associates in Sanming city: an interpersonal relationship-based analysis[J]. Chinese Journal of Public Health, 2022, 38(1): 99-104. DOI: 10.11847/zgggws1131796new

三明市农村糖尿病患者医疗服务人际连续性特征及其影响因素分析

Continuity of health care for rural diabetic patients and its associates in Sanming city: an interpersonal relationship-based analysis

  • 摘要:
      目的  了解福建省三明市农村糖尿病患者医疗服务人际连续性特征及其影响因素,为提高农村基层卫生服务连续性提供参考依据。
      方法  收集三明市新型农村合作医疗普通门诊数据库中2016年1 — 12月2606例就诊糖尿病患者的相关数据,采用家庭医生连续性比例(UPC)、服务连续性指数(COCI)和有序连续性指标(SECON)评价糖尿病患者的医疗服务人际连续性,并应用多因素非条件logistic回归分析模型分析其影响因素。
      结果  三明市农村糖尿病患者的医疗服务人际连续性总体较好,UPC、COCI和SECON中位数均为1;根据连续性数据特征,将UPC、COCI和SECON均分为高值和低值2组,UPC低值组为0~0.85(15.2 %),高值组为0.86~1(84.8 %);COCI低值组为0~0.81(14.39 %),高值组为0.82~1(85.61 %);SECON低值组为0~0.80(15.23 %),高值组为0.81~1(84.77 %);多因素非条件logistic回归分析结果显示,沙县地区、疾病总就诊次数 ≤ 5次、无并发症、主要就诊机构为县医院和乡镇卫生院的糖尿病患者UPC较高,尤溪地区的糖尿病患者UPC较低;沙县地区、疾病总就诊次数 ≤ 5次、无并发症、主要就诊机构为县医院和乡镇卫生院的糖尿病患者COCI较高,尤溪地区的糖尿病患者COCI较低;男性、疾病总就诊次数 ≤ 5次、无并发症、主要就诊机构为县医院和乡镇卫生院的糖尿病患者SECON较高,尤溪地区的糖尿病患者SECON较低。
      结论  三明市农村糖尿病患者的医疗服务人际连续性总体较好,地区、疾病总就诊次数、有无并发症和主要就诊机构是该地区糖尿病患者医疗服务人际连续性的主要影响因素。

     

    Abstract:
      Objective  To examine characteristics and influencing factors of continuity of health care for rural diabetic patients in Sanming city of Fujian province from the perspective of interpersonal relationship for providing references to improve continuous health care for rural diabetic patients.
      Methods  The data of 2016 on 2 606 rural diabetic patients in Sanming municipality of Fujian province were extracted from outpatient records registered in New Rural Cooperative Medical System. The interpersonal relationship-related continuity of health care for the diabetic patients was evaluated with following three indicators: usual provider of care (UPC), continuity of care index (COCI), and sequential continuity (SECON). Unconditional multivariate logistic regression analysis was performed to analyze influencing factors of the continuity of health care.
      Results  The interpersonal relationship-related continuity of health care was generally good among the diabetic patients, with the same median value of 1 for UPC, COCI, and SECON. The proportions of the patients with high values of UPC (0.86 – 1), COCI (0.82 – 1), and SECON (0.81 – 1) were 84.80%, 85.61%, and 84.77%; while the proportions of the patients with low values of UPC (0 – 0.85), COCI (0 – 0.81), and SECON (0 – 0.80) were 15.20%, 14.39%, and 15.23%, respectively. The results of unconditional multivariate logistic regression analysis demonstrated that the patients in Shaxian region, visiting a doctor for 5 times or less during the year, without a complication, and seeking medical service mainly in county level or township institutions were more likely to have a high value of both UPC and COCI, while those in Youxi region were more likely to have a low value of both UPC and COCI; the patients being male, visiting a doctor for 5 times or less during the year, without a complication, and seeking medical service mainly in county level or township institutions were more likely to have a high value of SECON but those in Youxi region were more likely to have a low value of SECON.
      Conclusion   The interpersonal relationship-related continuity of health care is generally good and mainly influenced by residential region, yearly frequency of visiting a doctor, situation of complication, and the grade of medical institution frequently being visited for medication among diabetic patients in rural region of Sanming municipality.

     

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