Evaluation Of Diabetes Management Effect Of Basic Public Health Services Based On Follow-up Populations In 8 Provinces And Autonomous Region

Objective:Understand the current status of diabetes management projects in basic public health services in 8 provinces and autonomous region in China,evaluate the effect of blood glucose control in patients with diabetes archiving during follow-up,analyze the influencing factors of blood glucose control,and provide suggestions for improving the basic public health services.Methods:This study is a follow-up survey based on the follow-up populations in 8 provinces and autonomous region in China,using a stratified multi-stage random sampling method.In 2012,eight provinces and autonomous regions were selected in the country,and each province and autonomous region selected one city,including Huai'an City in Jiangsu Province,Shangyu City in Zhejiang Province,Nanchang City in Jiangxi Province,Xiaogan City in Hubei Province,Mianyang City in Sichuan Province and Nanning City in Guangxi Autonomous Region.Municipalities,Yuxi City inYunnan Province and Urumqi City,Xinjiang Uygur Autonomous region,one district and one county were selected in each city as the research site,a total of 45 grassroots medical and health service institutions in 15 districts and counties.A total of 3,700 diabetic patients aged 35 years and over who have been selected from basic medical and health institutions to participate in basic public health services for diabetes management projects for one year.The influencing factors of blood glucose control in diabetic patients were investigated and they were followed in 2015.Using questionnaires,physical examinations,and extracting health record information,we obtained information on the fasting blood glucose levels and participation management dates in diabetic patients,and extracted the follow-up records and diagnosis and treatment records of patients' health records from 2012 and 2015,and investigated the patients' records of Drug treatment situation.The follow-up members were 2147.With reference to 2015 "Basic Public Health Service Chronic Diseases Patient Management Project and Evaluation of Elderly Health Work" and "National Basic Public Health Service Specification(2011 Edition)" type ? diabetes patient health management service specification,etc.,age,hypoglycemia response,Adverse drug reactions,compliance,medication compliance,single use,combination use,insulin use and metformin use,etc.were analyzed.Data were analyzed using t'-test,?2 test,Spearman rank correlation,Wilcoxon rank sum test,and multiple regression analysis for the two cross-sectional data for 2012 and 2015.Results:1 Analysis of the effect of blood glucose controlIn terms of follow-up frequency and blood glucose control rate,with 4 or more follow-up times one year in the follow-up group,44.58%of blood glucose control standards were met in 2012,and 72.2%of follow-up patients achieved blood glucose standardization in 2015(P<0.05);In the follow-up group less than 4 times one year,36.82%of the follow-up people in 2012 and58.92%in 2015 had reached the standard of blood glucose levels(P<0.05).In the follow-up group in 2012,blood glucose control rate of the single-drug was 43.46%,which was significantly less than blood glucose control rate of the combination drug(71.96%)(x2=5.96,P<0.05).In 2015,there was no significant difference in single-drug and combination drug for blood glucose control rate(x2=1.75,P=0.185).The percentage of single-drug in the follow-up population was higher than the percentage of combined drugs,but the proportion of combined drugs in the follow-up population was increased in 2015.Metformin remained as the most basic drug in the follow-up of diabetes.In 2015,the rate of metformin used to control diabetes in the follow-up populations was 68.76%higher than the rate of 42.07%achieved in 2012.However,there was no significant difference in the use of metformin to control diabetes in the follow-up period between 2012 and 2015(P>0.05).Age is always a factor that affects blood glucose,with significant statistical significance,P<0.05,and the regression coefficient is-0.011<0.The older the age,the lower the blood glucose control.The standard of blood glucose control in the follow-up populations with diabetes compliance with the law of good medical practice and adherence to medication is the highest,and with the deterioration of compliance behavior and medication compliance,the blood glucose control ratio is gradually reduced,P<0.05.The follow-up population was followed up,medication compliance or compliance behavior was improved,and the blood glucose control ratio was correspondingly increased.2 Follow-up blood glucose changesThe blood sugar level of 6.53(5.9?7.6)in urban diabetic follow-up population in 2012 was lower than 7.3(6.2?9)in rural diabetic follow-up group,P<0.05;the blood glucose level in urban diabetic follow-up population in 2015 was 6.4(5.8?6.9),it was lower than 6.5(5.8?7.6)of the follow-up population in rural areas with diabetes,P<0.05;Whether in 2012 or 2015,the blood glucose levels in rural diabetics were significantly higher than those in urban areas.The blood glucose level of rural diabetic follow-up population decreased significantly from 2012 to 2015,from 7.3(6.2 to 9)to 6.5(5.8 to 7.6),P<0.05;blood glucose level of urban diabetic follow-up population between 2012 and 2015 there was a significant decrease from 6.53(5.9 to 7.6)to 6.4(5.8 to 6.9),P<0.05.3 Follow-up people's blood glucose influencing factorsFor the entire follow-up group,age and compliance behavior were always the influencing factors of blood glucose control;For both rural and urban follow-up populations,insulin medication was always the influencing factor in rural diabetic follow-up population,and age and compliance behavior have always been the influencing factors in urban diabetes follow-up.Conclusion:The control rate of blood glucose in urban populations was significantly higher than that in rural areas;The glycemic control rate of the diabetic follow-up populations increased to varying degrees,but none of them exceeded the expected target except for Nanning City;The blood glucose levels of the follow-up populations decreased significantly,and the rural diabetic follow-up population blood glucose levels were all significantly higher than that of the city's.Age and compliance behavior are always the factors affecting blood glucose in the entire populations;Insulin medication has always been the influencing factor of blood sugar in the follow-up populations of rural diabetes.Age and compliance behaviors are the influencing factors of blood glucose in urban diabetic follow-up populations.