摘要
Abstract
Background Primary health institutions serve as the frontline defense against hypertension and diabetes.Their capabilities are critical to China's ability to effectively prevent and control these two chronic conditions.Objective To analyze the current situation of health management and treatment services provided by community hospitals in China for patients with hypertension and diabetes to identify problems and make suggestions.Methods The"Quality Service Grassroots Activities Application System"collected information on hypertension and diabetes prevention and treatment capacity and service provision in 3 718 community hospitals.Descriptive statistical analysis and multiple linear regression analysis were carried out based on Stata15.0.Results There were statistically significant differences in the allocation of electrocardiogram machines and peripheral blood glucose meters among primary health institutions across different regions(P<0.001).Similarly,significant regional disparities were observed in the availability of essential antihypertensive and hypoglycemic medications(P<0.001).The annual number of hypertension and diabetes diagnoses and treatments per institution also varied significantly by region(P<0.001).Additionally,significant differences were found in the renewal rates of hypertensive and diabetic patients across regions(P<0.001).Furthermore,significant variations were observed among regions in the standardized management rates of hypertensive and diabetic patients,as well as in blood pressure and blood glucose control rates(P<0.001).Multiple linear regression analysis revealed that factors such as region,institution type,the number of essential antihypertensive drugs available,the number of registered general practitioners,the proportion of medical income to total income,the proportion of medical insurance income to medical income,and the contract renewal rate significantly influenced the annual number of diagnosed and treated hypertensive patients(P<0.05).Similarly,region,institution type,the number of practicing(assistant)physicians,the proportion of medical income to total income,and the renewal rate were found to affect the standardized management rate of hypertensive patients(P<0.05).Moreover,region,institution type,the number of electrocardiogram machines,the number of practicing(assistant)physicians,and the proportion of medical income to total income had statistically significant effects on blood pressure control.Conclusion The hardware conditions of community hospitals in the western region are better,but the medical service capacity is not as good as that in the east,and the soft power still needs to be improved.The ECG machine is the best,but the peripheral blood glucose meter,drug equipment,diagnosis and treatment times and other indicators that reflect the ability of medical services are not as good as those in the east.The integration of medical prevention of hypertension and diabetes still needs to be implemented,and public health indicators such as standardized management rate and blood pressure and blood glucose control rate are"decoupled"from the medical service capacity of community hospitals,and the indicators related to medical services and public health services are"inverted",with the former being high in the east and the latter in the west,and the quality and service connotation of public health data need to be improved.关键词
高血压/糖尿病/基层医疗卫生机构/慢性病防治/医防融合Key words
Hypertension/Diabetes mellitus/Community hospital/Prevention and treatment of chronic diseases/Integration of treatment and prevention分类
医药卫生
