Evaluation Of The Clinical Results Of Capitation Reform Of Payment System On Diabetes Mellitus

Objective:By comparing the diabetes capitation payment project into the group of patients and not into the group of patients with body mass index(BMI),fasting glucose,glycosylated hemoglobin,homocysteine(HCY)and low density lipoprotein cholesterol(LDL-C),urine beta 2 microglobulin,urine trace albumin,urinary albumin/creatinine ratio(ACR),estimated glomerular filtration rate(e GFR),and other clinical indicators and clinical achievement rate,this research evaluate the clinical effect of diabetes capitation payment project from the clinical curative effect,and give some suggestions to the future work of the diabetes capitation payment.Methods: This research randomly selected 101 type 2 diabetes patients who joined in the diabetes capitation payment project to enter the observation group in Tianjin Nankai District Santan hospital from January 2017 to December 2017,and randomly selected 100 type 2 diabetes patients who didn't join in the diabetes capitation payment project to enter the control group in Tianjin Nankai District Santan hospital from January 2017 to December 2017,and compared the clinical indicators and achievement rate of two groups patients.Results: 1.There was no significant differences in gender,age,history,complications,height,weight,BMI and other general data between the observation group and control group(P>0.05).2.There has significant differences in fasting blood glucose,glycosylated hemoglobin,ACR,e GFR and other clinical indicators between observation and control group(P<0.05),and the observation group has a lower level of fasting blood glucose,glycosylated hemoglobin is low,ACR,high clinical index of e GFR compare with control group.There was no significant differences in the clinical indicators of HCY,LDL-C,urina-2 microglobulin and urine microalbumin(P>0.05).3.The achievement rate of fasting glucose,glycosylated hemoglobin and LDL-C was statistically significant difference(P<0.05)between observation and control group.It is better in observation group for blood sugar,glycosylated hemoglobin,LDL-C clinical index compare with control group,but the achievement rate is low,the achievement rate of fasting glucose respectively 47.52%,35.64% achievement rate for glycosylated hemoglobin and LDL-C achievement rate was 24.75%.There is no significant differences between observation and control group in achievement rate of BMI,HCY,urine beta 2 microglobulin,urine trace albumin,ACR complying,and e GFR(P>0.05).Conclusion: Diabetes capitation payment project management mode has obvious clinical effect for controlling fasting glucose,glycosylated hemoglobin and its achievement rate for type 2 diabetes patients,but has no clinical effect for controlling chronic kidney complications and cardiovascular risk for type 2 diabetes patients.