家庭医生签约模式下预约门诊对糖尿病患者管理效果的影响

陈吉 邝海东 张晓琼 刘阳

摘 要 目的：分析家庭医生签约模式下预约门诊对社区糖尿病患者的管理效果。方法：2019年第一季度在上海宜川街道社区卫生服务中心接受预约就诊和未接受预约就诊的2型糖尿病患者中各抽取110人分别纳入观察组和对照组。观察组110例患者中，女性56例，男性54例，平均年龄（68.95±2.67）岁；对照组110例患者中，女性53例，男性57例，平均年龄（69.05±2.62）岁。观察组患者接受分时段预约门诊管理，对照组患者接受家庭医生签约简易门诊管理。比较入组前和管理1年后的糖尿病知识知晓率、依从性、血糖和血压控制率。结果：1年后，观察组的糖尿病知晓率、依从性、血糖控制率、血压控制率均明显优于对照组（70.9%比55.0%、72.7%比54.5%、71.8%比53.6%、65.5%比52.7%，P<0.05）。结论：家庭医生签约模式下的预约门诊服务有助于提高社区糖尿病患者的管理效果。

关键词 糖尿病；家庭医生；预约门诊；管理

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2021）06-0053-03

The impact of appointment of outpatient clinics on the management of diabetic patients under the family doctor contract mode

CHEN Ji1， KUANG Haidong1， ZHANG Xiaoqiong1， LIU Yang2（1.General Practice Department of Yichuan Community Health Service Center of Putuo District， Shanghai 200065， China； 2.Geriatric Medicine Department of Tongji Hospital， Shanghai 200065， China）

ABSTRACT Objective： To analyze the management effect of outpatient appointment in community diabetes patients under family doctor contract mode. Methods： In the first quarter of 2019， 110 patients with type 2 diabetes who received an appointment and 110 patients with type 2 diabetes who did not receive an appointment in Yichuan Community Health Service Center， Shanghai were selected into an observation group and a control group. In 110 patients in the observation group， there were 56 females and 54 males with an average age of （68.95±2.67） years； in 110 patients in the control group， there were 53 females and 57 males with an average age of （69.05±2.62） years. The patients in the observation group received the management of outpatient appointment in different periods， while the patients in the control group received the simple outpatient management signed by family doctors. The diabetes knowledge awareness rate， compliance， blood sugar and blood pressure control rate before enrollment and one year after management were compared. Results： One year later， the diabetes awareness， compliance， blood sugar control rate， and blood pressure control rate in the observation group were significantly better than those in the control group（70.9% vs. 55.0%， 72.7% vs. 54.5%， 71.8% vs. 53.6%， 65.5% vs. 52.7 %， P<0.05）. Conclusion： The appointment of outpatient services under the family doctor contract mode can help improve the management effect of diabetes patients in the community.

KEY WORDS diabetes； family doctor； outpatient appointment； management

糖尿病是一種常见病、多发病，是继肿瘤和心血管疾病后导致死亡的第3大病因，严重影响患者的健康及生活质量[1-2]。糖尿病的治疗需要多方面的综合管理[3-4]。家庭医生签约模式下的社区分时段预约门诊可为糖尿病患者提供连续、主动的健康管理服务，提高糖尿病患者的自我健康管理意识。本文通过分析家庭医生签约模式下的预约门诊服务对2型糖尿病患者的管理效果，为开展社区预约门诊服务提供参考。

1 对象与方法

1.1 对象

2019年第一季度在上海宜川街道社区卫生服务中心接受预约就诊的2型糖尿病患者中抽取110人纳入观察组，在未接受预约就诊的2型糖尿病患者中抽取110人纳入对照组。……