本文選題：型糖尿病 + 就診傾向��； 參考：《復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版)》2017年02期

【摘要】：目的了解重慶市慢病管理系統(tǒng)中2型糖尿病患者就診傾向及其影響因素。方法采用多階段整群隨機(jī)抽樣調(diào)查患者的基本信息、過(guò)去一年與糖尿病有關(guān)的就診情況,包括首選就診醫(yī)療機(jī)構(gòu)、選擇該機(jī)構(gòu)的原因等。以社區(qū)就診為參照,利用多分類Logistic回歸模型計(jì)算相對(duì)危險(xiǎn)度比值(relative risk ratio,RRR)及其影響因素。結(jié)果調(diào)查前一年內(nèi),2型糖尿病患者中有38.02%傾向縣級(jí)以上醫(yī)院就診,有36.78%傾向藥房/診所就診,有25.21%傾向社區(qū)就診。單因素分析結(jié)果表明,不同受教育程度、家庭年人均收入水平、醫(yī)保類型、治療方式的人群就診傾向存在差異。多分類Logistic回歸結(jié)果表明,受教育程度較高(RRR=2.39,95%CI:1.20~4.78)、收入水平高(RRR=3.37,95%CI:1.44~7.88)、申請(qǐng)到門診特殊疾病醫(yī)療保險(xiǎn)(RRR=3.32,95%CI:1.72~6.42)、同時(shí)采用胰島素和口服降糖藥(RRR=5.02,95%CI:1.15~22.00)的被調(diào)查者更傾向于在縣級(jí)以上醫(yī)院就診,而不是利用社區(qū)衛(wèi)生服務(wù)。結(jié)論重慶市2型糖尿病患者傾向于在縣級(jí)以上醫(yī)院就診。2型糖尿病作為慢性非傳染性疾病中的重要病種,患者主體尚未轉(zhuǎn)移到社區(qū)接受服務(wù)。
[Abstract]:Objective to investigate the visiting tendency and influencing factors of type 2 diabetes mellitus in chronic disease management system in Chongqing. Methods the basic information of patients with diabetes mellitus was investigated by multi-stage cluster random sampling, including the first choice of medical institutions and the reasons for selecting them. The relative risk relative risk ratio (RRR) and its influencing factors were calculated by using multi-classification Logistic regression model. Results in the previous year, 38.02% of the patients with type 2 diabetes tended to seek medical treatment in hospitals above county level, 36.78% in pharmacies / clinics and 25.21% in communities. Univariate analysis showed that there were differences among different education levels, family annual income level, type of medical insurance and treatment. The results of multi-classification Logistic regression showed that those with a higher education level, with a higher level of education, with a higher education level of 2.39% or 95% CI1: 1.20 / 4.78, with a high income level of 3.3795%, CI1: 1.447.88, apply for medical insurance for outpatient special diseases, and apply for medical insurance for outpatient special diseases, RRRN 3.3295 / 95: 1.726.42%, and those who also use insulin and oral hypoglycemic drug RRRU 5.0295 CI$ 1.15-22.00 are more likely to see a doctor at a hospital above the county level. Instead of using community health services. Conclusion Type 2 diabetes patients in Chongqing tend to visit hospitals above county level as an important disease of chronic non-communicable diseases, but the main body of patients has not been transferred to the community to receive services.
【作者單位】： 重慶醫(yī)科大學(xué)公共衛(wèi)生與管理學(xué)院流行病學(xué)教研室-醫(yī)學(xué)與社會(huì)發(fā)展研究中心-健康領(lǐng)域社會(huì)風(fēng)險(xiǎn)預(yù)測(cè)治理協(xié)同創(chuàng)新中心;重慶市疾病預(yù)防控制中心慢性非傳染性疾病預(yù)防控制所;美國(guó)杜克大學(xué)全球健康研究所;
【基金】：美國(guó)杜克大學(xué)國(guó)際合作項(xiàng)目(X7383) 重慶市衛(wèi)生計(jì)生委面上項(xiàng)目(20142111)~~
【分類號(hào)】：R587.1

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