摘要
目的评价实施家庭医生制度下2型糖尿病患者双向转诊的效果。方法选取150例2型糖尿病患者进行3年的治疗,每组各50例。A组为实施家庭医生制下双向转诊组,B组为实施家庭医生制下不执行双向转诊组,C组为自行就诊的患者。观察治疗后的患者体重指数(BMI)、腰臀比(WHR)、平均动脉压(MAP)、血糖(FBG、2h-PBG、Hb A1c)及血脂。观察糖尿病慢性并发症发生率、就诊满意度的变化情况。结果 1治疗3年后,A组患者的血糖、血脂控制情况明显优于B、C两组,A、B组的MAP显著低于C组(P值均<0.05)。2治疗3年后,A组患者的血糖、血脂的达标率高于B、C组患者(P<0.05,P<0.01);A、B组患者血压的达标率高于C组患者(P<0.01,P<0.05)。33年后肾脏、神经、眼部病变的并发症发生率A组分别上升8%(4/50)、2%(1/50)、2%(1/50),与B组上升14%(7/50)、2%(1/50)、6%(3/50),与C组上升24%(12/50)、6%(3/50)、12%(6/50)相比,差异均有统计学意义(P<0.05)。4A组患者在就诊便利性、住院便利性、医疗费用支出的满意度评分均高于B、C组(P<0.05,P<0.01)。结论 2型糖尿病在家庭医生制下实施双向转诊有助于血糖、血压、血脂控制及降低糖尿病慢性并发症的发生,有助于降低医疗费用的支出,提高患者满意度。
Objective To evaluate the effects of the two-way referral in patients with type 2 diabetes in the family doctor system. Methods 150 patients with type 2 diabetes were administrated for 3 years,they were divided into 3 groups with 50 patients in each group. Group A was the two-way referral group in the family doctor system,group B was non-two-way referral group in the family doctor system,and group C was self-referred patients. The changes of BMI,WHR,MAP,FPG,2h PG,Hb Alc and Lipids were observed. The incidence of diabetic chronic complications and the change of clinic satisfaction were compared. Results ① After 3 years of treatment,the blood glucose,blood lipid controlled in group A was better than that of groups B and C（ P〈0. 05,P〈0. 01）. MAP in group A and B was significantly lower than that of group C（ P〈0. 01,P〈0. 05）. ②After 3 years of treatment,the compliance rate of blood glucose,blood lipid in A group was higher than groups B and C. Blood pressure was controlled better in group A and B as compared with group C. ③After 3years,the rates of eye,kidney and nerve disease complication increased 8%（ 4 /50）,2%（ 1 /50）,2%（ 1 /50） in group A,14%（ 7 /50）,2%（ 1 /50） and 6%（ 3 /50） in group B,and 24%（ 12 /50）,6%（ 3 /50） and 12%（ 6 /50） in group C,there were significant differences（ P〈0. 05）.④The patients satisfaction scores for the convenience visiting a doctor and hospitalized,and medical expenditure in group A were higher than those in group B and C（ P〈0. 05,P〈0. 01）.Conclusion The two-way referral in the family doctor system for patients with Type 2 diabetes will contribute to the control of blood glucose,blood lipid and blood pressure,and reduce chronic complications of diabetes. It may help to reduce medical expenditure and improve patient satisfaction.
出处
《中华全科医学》
2015年第5期783-784,803,共3页
Chinese Journal of General Practice
关键词
糖尿病
双向转诊
社区卫生服务
家庭医生制度
Diabetes mellitus
Two-way referral
Community health service
Family doctor system
