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目的分析高血压和糖尿病患者预防服务(规范化管理)、门诊及住院服务利用情况及影响因素。方法利用2014年“基层卫生综合改革重点联系点”需方家庭健康询问调查数据,建立高血压、糖尿病患者分析数据库,分析高血压、糖尿病患者规范化管理、门诊及住院服务利用情况,并进行单因素χ2检验和多因素logistic回归分析。结果共调查≥15岁人口53 337人,其中高血压患者9 607人,糖尿病患者2 640人,规范化管理率分别为80.2%和78.3%,两周就诊率分别为41.3%和57.3%,住院率分别为33.2%和52.7%;多因素logistic回归分析结果显示,高血压和糖尿病患者接受规范化管理的主要影响因素为签约服务、年龄、城乡类型和地区等;门诊服务利用的主要影响因素为参加医疗保险类型、慢性病门诊补偿、文化程度、就业状况、城乡类型和地区等;住院服务利用的主要影响因素为收入水平、慢性病门诊补偿、文化程度、城乡类型和地区。结论签约服务可促进高血压和糖尿病患者接受规范化管理;参加城镇职工医保慢性病患者门诊服务利用率低,住院服务利用率高;慢性病门诊补偿政策能有效促进高血压和糖尿病患者留在门诊,减少住院。
Objective To analyze the use of prevention services (standardized management), outpatient and inpatient services and influencing factors in patients with hypertension and diabetes. Methods Based on the survey data of “Key Contact Points of Primary Health Comprehensive Reform” and “Family Health Questionnaire” in 2014, the database of hypertension and diabetes patients was established to analyze the utilization of standardized management, outpatient and inpatient services for patients with hypertension and diabetes. Univariate χ2 test and multivariate logistic regression analysis. Results A total of 53 337 persons aged 15 and over were enrolled. Among them, 9 607 were hypertensive patients and 2 640 were patients with diabetes. The standardized management rates were 80.2% and 78.3% respectively. The two-week visiting rates were 41.3% and 57.3% respectively. The hospitalization rate Respectively, 33.2% and 52.7% respectively. The results of multivariate logistic regression analysis showed that the main factors influencing the standardized management of hypertension and diabetes were signing service, age, urban and rural areas and regions, etc. The main influencing factors of outpatient service utilization were attending medical treatment Type of insurance, compensation for outpatient service of chronic disease, educational level, employment status, type of urban and rural areas, etc. The main influencing factors of inpatient service utilization are income level, outpatient service of chronic disease compensation, educational level, urban and rural types and regions. Conclusion The signing service can promote the standardized management of patients with hypertension and diabetes. The utilization rate of outpatient service for participating urban workers in chronic diseases is low, and the utilization rate of hospital services is high. The outpatient service compensation policy of chronic diseases can effectively promote the stay of hypertension and diabetics in the outpatient setting, .