卫生服务体系整合型改革中基层运行环境对糖尿病患者血糖控制的影响

目的:本研究分析多个维度的整合环境对2型糖尿病患者血糖控制情况的影响,为整合型卫生服务体系改革和提高糖尿病管理质量提供政策依据.方法:采用多阶段抽样,对6个省市75家基层医疗卫生机构及429例2型糖尿病患者进行问卷调查,构建两水平logistic回归模型分析血糖控制的关键影响因素.结果:74.13％的2型糖尿病患者自评...

Effect of primary operating environment on glycemic control of diabetic patients with type 2 diabetes in an integrated health service system reform

Objectives:To analyze the impacts from integrated environment of primary health institutions at multiple dimensions on glycemic control in patients with Type 2 diabetes, and provide policy basis for the reform of integrated health service system and the improvement of quality of diabetes management. Methods:A questionnaire survey based on multi-stage sampling was carried out among a total of 75 primary health institutions in 6 cities and 429 patients with Type 2 diabetes. A two-level logistic regression model was built to analyzes the key impact factors of glycemic control. Results:Effective self-rated glycemic control was achieved in 74.13% of the surveyed patients with Type 2 diabetes. The operating environment of primary health institutions was divided into five dimensions, i.e. service delivery, human resources, medical resource provision, health information system, and management mechanism. Each of these dimensions may have a different impact on glycemic control in patients with diabetes. Patients have received treatment from regular physicians and have received more than 4 times of follow-up visits in recent one year. The rate of correct answers to the comprehensive knowledge test for medical/health workers at primary medical and health institutions was high, and electronic health files and medical records are interconnected and sharing in information showed a significant positive correlation with optimal glycemic control in patients with type 2 diabetes. Conclusions:The building of a comprehensive and integrated environment is conductive to promoting the integration of medical and preventive services of primary healthcare institutions, improving the quality of diabetes management services, and enhancing glycemic control in patients with type 2 diabetes.