山东省糖尿病患者医防融合服务利用行为及影响因素研究OA
Investigation of Utilization Behaviors and Influential Factors in the Integration of Medical and Preventive Care for Diabetic Patients in Shandong Province
背景 随着社会经济的发展,糖尿病患病率逐年升高.糖尿病患者不仅需要治疗服务,也需要全面、连续的一体化医防融合服务.但是,由于"医防"割裂等原因,糖尿病患者医防融合服务利用存在一定不足.因此,改善糖尿病患者医防融合服务利用至关重要.目的 了解山东省糖尿病患者医防融合服务利用行为现况及其影响因素,为进一步完善医防融合相关政策与实践提供参考.方法 于 2023 年 8 月,采用多阶段分层整群随机抽样法,根据地理位置和经济发展状况,在山东省东、中、西部地区分别选择烟台市、潍坊市和聊城市,在每个地市选取 1 个县/县级市作为样本地区.在每个县/县级市分别随机选取 4 个乡镇,在每个乡镇分别随机抽取 2 个村,在每个村纳入基本公共卫生服务管理的糖尿病患者中随机抽取 25 例进行问卷调查.采用自制问卷调查糖尿病患者个人特征和医防融合服务利用行为,采用多因素 Logistic 回归分析探讨糖尿病患者医防融合服务利用行为的影响因素.结果 调查 602 例患者,最终收回600份有效问卷,问卷有效率为99.67%.糖尿病患者医防融合服务利用行为良好率为54.5%(327/600).不同受教育程度、居住情况、对医防融合认知、健康信念、家庭医生签约情况、是否合并其他慢性病、自评健康状况的糖尿病患者医防融合服务利用情况比较,差异有统计学意义(P<0.05).多因素 Logistic 回归分析结果显示,初中学历(OR=1.896)、对医防融合认知好(OR=5.818)、健康信念好(OR=2.701)、签约了家庭医生(OR=2.106)的糖尿病患者医防融合服务利用行为更好(P<0.05).结论 现阶段山东省糖尿病患者医防融合服务利用行为仍有较大的改善空间,应继续完善医防融合服务,提升家庭医生服务质量,加大对医防融合及相关政策的宣传力度.
Background With the development of the economy and society,the prevalence of diabetes has been increasing year by year.Diabetic patients require not only treatment services but also comprehensive and continuous integration of medical and preventive care.However,due to the fragmentation of"medical-preventive"services,there are certain deficiencies in the utilization of integration of medical and preventive care for diabetic patients.Therefore,improving the utilization of these services is crucial.Objective To understand the current status and influencing factors of the utilization of integration of medical and preventive care among diabetic patients in Shandong Province,and to provide references for further improving related policies and practices.Methods In August 2023,a multi-stage stratified cluster random sampling method was employed.Based on geographical location and economic development,Yantai City,Weifang City,and Liaocheng City were selected from the eastern,central,and western regions of Shandong Province,respectively.From each city,one county/county-level city was chosen as a sample area.Within each county/city,four townships were randomly selected.From each township,two villages were randomly chosen.In each village,25 diabetic patients included in the basic public health service management were randomly selected for a questionnaire survey.A self-designed questionnaire was used to investigate the personal characteristics of diabetic patients and their utilization behavior of integrated medical and preventive care services.Multivariate Logistic regression analysis was used to explore the factors influencing diabetic patients'utilization behavior of integrated medical and preventive care services.Results A total of 602 patients were surveyed,and 600 valid questionnaires were collected,with a validity rate of 99.67%.The good utilization rate of integration of medical and preventive care among diabetic patients was 54.5%(327/600).There were statistically significant differences in the utilization of these services among patients with different education levels,living conditions,awareness of integration of medical and preventive care,health beliefs,family doctor contracting status,presence of other chronic diseases,and self-rated health status(P<0.05).Multivariate Logistic regression analysis showed that patients with junior high school education(OR=1.896),good awareness of integration of medical and preventive care(OR=5.818),good health beliefs(OR=2.701),and those who had contracted a family doctor(OR=2.106)had better utilization behavior integration of medical and preventive care(P<0.05).Conclusion At present,there is still significant room for improvement in the utilization of integration of medical and preventive care among diabetic patients in Shandong Province.Efforts should be made to further improve these services,improving the quality of family doctor services,and increase the publicity of integration of medical and preventive care and related policies.
范文瑜;冯霞;张世龙;马兴丽;张馨丹;赵洋;王海鹏
250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心||250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心||250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心||250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心||250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心||250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)2050 澳大利亚悉尼,新南威尔士大学乔治全球健康研究院||3010 澳大利亚墨尔本,墨尔本大学人口与全球健康学院250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心||250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)
医药卫生
糖尿病医防融合卫生服务利用横断面研究山东
Diabetes mellitusIntegration of medical and preventive careUtilization of health servicesCross-sectional studiesShandong
《中国全科医学》 2026 (22)
3192-3198,7
山东大学国家治理研究院23B05课题阶段性研究成果(23B05)
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