Zhongguo quanke yixue (Jan 2022)
Utilization of National Essential Public Health Services and Its Relationship with Management Effect in Chinese Type 2 Diabetic Patients
Abstract
BackgroundThe national essential public health services (NEPHS) , which have been implemented since 2009, may be the largest population-based intervention practice for Chinese patients with diabetes currently. It is important to understand the utilization and management effect of such services in diabetic population over this period of more than 10 years of development.ObjectiveTo understand the utilization and management effect of NEPHS as well as their association in Chinese type 2 diabetics.MethodsBy use of multi-stage stratified sampling, 1 527 type 2 diabetics (≥35 years old) were selected from 20 community (township) health centers in 10 districts (counties) of 5 cities in eastern, central and western China during November to December 2019. Sociodemographic characteristics, utilization and management effect of NEPHS in these patients were collected by face-to-face surveys with a self-designed questionnaire.ResultsAccording to the survey, patients' self-reported rates of creating health records, use of health records, undergoing standardized blood glucose tests, and receiving standard follow-ups were 90.34% (1 375/1 522) , 52.80% (725/1 373) , 83.69% (1 262/1 508) , and 90.18% (1 377/1 527) , respectively. Household follow-ups and hospital follow-ups accounted for 29.24% (443/1 515) and 61.06% (925/1 515) of the total last follow-ups, respectively. The analysis of management effect showed that patients' self-reported rates of home-based self-monitoring blood glucose and regular medication in the past 6 months were 53.57% (818/1 527) , and 89.26% (1 363/1 527) , respectively. The rates of patients who were satisfied with glycemic control, and overall medical services assessed in the last follow-up were 65.23% (996/1 527) , and 95.15% (1 453/1 527) , respectively. In those≥65 years old, the prevalence of home-based self-monitoring blood glucose differed significantly by the creation of health records and Chinese medicine services (P<0.05) . The prevalence of regular medication differed significantly by number of follow-ups (P<0.05) . The level of overall satisfaction with services differed significantly by the access to personal medical records at any time, Chinese medicine services, number of home-based self-monitoring blood glucose, and type of follow-up (P<0.05) . In those aged from 35 to 64, the prevalence of home-based self-monitoring blood glucose differed significantly by the creation of health records, access to personal medical records at any time, Chinese medicine services, number of blood glucose testing, and number of follow-ups (P<0.05) . The prevalence of regular medication differed significantly by the type of follow-up (P<0.05) . The satisfaction rate of blood glucose control differed significantly by access to personal medical records at any time (P<0.05) . The overall service satisfaction rate differed significantly by follow-up type and creation of health records (P<0.05) .ConclusionNEPHS have influenced community-based management of type 2 diabetic patients, the standard implementation of which has enhanced the management effect and the overall service satisfaction in these patients.
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