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目的虽然与医生建立长期关系是初级保健的特征,但在慢性疾病管理中,很少有研究对此作用做出评价。本研究目的是调查有自己医生的糖尿病患者其治疗目标是否得到改善。方法使用糖尿病登记资料,将确诊为糖尿病6个月的患者,基于他们有或无自己的医生分为两组,对比分析两组患者的糖化血红蛋白、血压、低密度脂蛋白胆固醇及治疗达标率。结果有自己医生的糖尿病患者其年龄比无自己医生的糖尿病患者略大(57.5岁vs50.9岁,P=0.002),但性别分布和吸烟率二者相同。在糖尿病特性评估中,有自己医生的糖尿病患者糖化血红蛋白的平均水平要低(7.70vs8.53,P=0.01),但达到目标≤7.0的百分数无差异。两组患者的收缩压、舒张压、低密度脂蛋白胆固醇水平及对这些测量的认知率比较无明显差异。调查其他预防服务,有医生的患者前一年更有可能接种流感疫苗(51.8%vs35.6%;P=0.02),但接种肺炎双球菌疫苗或每天用阿司匹林的可能性不大。结论此研究提示糖尿病患者有自己的医生所带来的益处并未超过有常规医疗服务设施的患者。
PURPOSE Although establishing long-term relationships with physicians is a characteristic of primary care, few studies have evaluated this role in chronic disease management. The purpose of this study was to investigate whether the treatment goals of diabetics with their own physicians have been improved. Methods Using diabetes registration data, patients diagnosed with diabetes for 6 months were divided into two groups based on whether they had their own doctor or not. The levels of HbA1c, blood pressure, low density lipoprotein cholesterol, and treatment compliance rates were compared between the two groups. As a result, diabetics with their own physicians were slightly older (57.5 vs. 50.9 years, P = 0.002) than their nondiabetic counterparts, but their gender distribution and smoking rates were the same. In the assessment of diabetic characteristics, the average level of HbA1c in diabetic patients with their own physicians was lower (7.70 vs. 8.53, P = 0.01), but there was no difference in reaching the target of ≤7.0. Systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol levels and cognitive rate of these measurements were not significantly different between the two groups. Investigating other preventive services, patients with physicians were more likely to have been vaccinated against influenza the year before (51.8% vs35.6%; P = 0.02), but vaccination with pneumococcal vaccine or aspirin daily is unlikely. Conclusions This study suggests that the benefits of having their own doctor in patients with diabetes do not outweigh the benefits of having regular healthcare facilities.