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目的了解社区糖尿病患者卫生服务利用情况及存在的问题,为制定政策提供依据。方法在山东省和江苏省部分县(市、区)采取随机抽样方式调查糖尿病患者1 508例。通过面对面问卷调查了解糖尿病患者诊治情况和卫生服务利用情况。结果 53.3%的糖尿病患者由社区卫生服务机构发现或诊断糖尿病;75.6%的患者首选到社区卫生服务机构治疗糖尿病;在1年内曾经到社区卫生服务机构就诊的城市和农村糖尿病患者的比例分别为85.3%和91.6%,差异有统计学意义(χ2=14.6,P<0.01);在1年内曾参加社区举办的健康教育活动的城市和农村糖尿病患者的比例分别为62.6%和77.8%,差异有统计学意义(χ2=41.6,P<0.01);城市和农村患者近1年内获得门诊随访、家庭访视或电话随访4次以上的比例差异均有统计学意义(χ2值分别为10.4、93.1、113.6,P<0.01)。结论糖尿病患者就医观念和模式正在发生改变,对社区医疗机构的需求增加,应提高社区卫生服务机构卫生资源利用率和工作效率,加大社区健康教育力度,完善社区卫生服务体系。
Objective To understand the utilization of health services and its existing problems in community diabetic patients and provide the basis for the formulation of policies. Methods A total of 1 508 diabetic patients were investigated by random sampling method in some counties (cities and districts) in Shandong Province and Jiangsu Province. Through face-to-face questionnaires to understand the diagnosis and treatment of diabetes and health services utilization. Results 53.3% of diabetic patients were found or diagnosed as diabetes by community health service agencies; 75.6% preferred to community health service institutions for diabetes treatment; and the proportions of urban and rural diabetic patients who visited community health service institutions within one year were 85.3 % And 91.6%, respectively (χ2 = 14.6, P <0.01). The proportions of urban and rural diabetes patients who participated in community-based health education activities within one year were 62.6% and 77.8%, respectively, with statistical differences (Χ2 = 41.6, P <0.01). There was significant difference in the proportion of outpatient visits, home visits or telephone follow-ups of 4 times in both urban and rural areas (χ2 = 10.4, 93.1, 113.6 , P <0.01). Conclusion The concept and mode of medical treatment for diabetic patients are changing. The demand for community health care institutions is increasing. The utilization rate of health resources and efficiency of community health service institutions should be increased. Community health education should be stepped up and the community health service system should be improved.