Research On The Continuity Of Medical Services For Diabetic Patients

Objective:The current medical and health service system is still relatively fragmented and fragmented in China.Continuity of care is considered an inevitable choice to bridge the gap in health services between institutions.This study used foreign service continuity evaluation indicators to evaluate the differences in the continuity of diabetes patients in City F from different perspectives,explored the influencing factors of medical service continuity,clarified the operation mechanism of vertical medical service continuity,and provide regional vertical medical services in Fujian Province Continuous operation mode proposes optimization suggestions,Provided optimization suggestions for the continuous operation mode of the regional vertical medical service in Fujian Province.Methods:Through the literature review method,the definition of the continuity of medical services at home and abroad was clarified,the continuity evaluation system of medical services at home and abroad was combed,and the research hotspots and development trends of existing evaluation indicators were explored.Extracting the2018-2019 outpatient information of diabetic patients from the medical insurance database of urban and rural residents in F City,used the international indicators UPC,COCI,UPC to measure the continuity of care,and explored the influencing factors of the continuity of care through medical statistical analysis.Through interviews to understand the dynamic resistance factors of health service providers,relevant administrative departments,etc.in the continuous medical service provision process,and explore the operation mechanism of medical service continuity.Statistical analysis used SPSS 23.0 for descriptive analysis,single factor analysis,regression analysis;qualitative research used software bicomb2.0,ucinet6.1,netdraw2.0 to sort out domestic and foreign continuous service evaluation indicators,and used NVivo11.0qualitative analysis software Coding and arranging the interview results.Results:The continuity of care of patients with diabetes in City F from 2018 to 2019 is generally good.UPC,COCI and SECON are used to comprehensively evaluate the continuity of patient medical services.There were 32,811 patients(87.4%)in the high group of continuity of care,and there were 4717 patients(12.6%)in the low group.Most patients have stable habit of visiting institutions,and their continuity of care was high;patients with low continuity were not "completely disordered",although there were multiple medical institutions,there were at least 1-2 medical institutions as their main medical institutions.The main influencing factors for diabetic patients in F city include whether they are urban areas,gender,the number of diabetes visits,the total number of visits for the disease,whether it is a complication,and the main medical institutions.In rural areas,men,the more frequent diabetic consultations,the lower the total number of consultations for the disease,no complications,the continuity of patients whose main consultation institutions are in county-level hospitals,municipal hospitals and above is higher.The operating mechanisms of medical service continuity in the macro,meso,and micro perspectives were the interest coordination mechanism of government departments,the division of labor and cooperation mechanism of the vertical medical service network,and the interaction mechanism between doctors and patients.Conclusions:The continuity of care of medical services for diabetic patients in City F is generally at a relatively high level,but it was showing a trend of increasing medical treatment,and the effectiveness of the hierarchical diagnosis and treatment and the first-diagnosis system at the grassroots level had initially appeared.According to the influencing factors of patient continuity of care and the results of regional medical service continuity operation mechanism,it is necessary to re-establish the basic concept of "system integration",clarify the goal of continuous service reform,grasp the key points of service continuity,balance the interests and risks of the supplier,and play the fundamental role of informatization construction.