2021年度南京基层医疗卫生机构糖尿病管理能力现状调查-现代医学

2021年度南京基层医疗卫生机构糖尿病管理能力现状调查

单位：1. 南京医科大学公共卫生学院, 江苏南京 211166;
2. 南京市基层卫生协会, 江苏南京 211166

分类号：R11

出版年·卷·期（页码）：2025·53·第三期（431-437）

摘要：

目的：本研究旨在调查南京市基层医疗卫生机构糖尿病管理现状，为评估全市糖尿病管理能力提供参考依据。方法：采用问卷对南京市133家基层医疗卫生机构进行调查，调查内容包括基层机构糖尿病管理的相关情况、基本设备配置(包括可配备的糖尿病并发症筛查项目)、基本药物配备情况。结果：城区开展糖尿病精细化管理的基层医疗卫生机构与郊区相比，差异无统计学意义(85.5% vs. 84.5%，P=0.875)。医务人员人数在两区基层医疗卫生机构分布差异无统计学意义。在133家基层医疗卫生机构配备的糖尿病及其并发症筛查检测项目上，3种检测项目城区配备率高于郊区，分别为晨尿白蛋白(87.1% vs. 66.2%, P=0.009)、颈动脉B超(91.9% vs. 40.8%, P<0.01)、心功能检测项目(51.6% vs. 29.6%, P=0.016)。在降糖药物配备上，有12种药物城区基层医疗卫生机构配备率高于郊区(均P<0.05)，城区以二甲双胍0.50 g·片^-1使用最为常见。结论：大部分基层医疗卫生机构已开展糖尿病精细化管理，基层医疗卫生机构应该加大部分糖尿病及其并发症筛查设备投入，并增加降血糖药物的配备。

Objective: This study aimed to investigate the current status of diabetes management in grassroots medical and health institutions in Nanjing, providing a reference for assessing the city's overall diabetes management capacity. Methods: A questionnaire survey was conducted across 133 grassroots medical and health institutions in Nanjing. The survey covered the diabetes management practices in these institutions, basic equipment configurations(including available screening projects for diabetes complications), and the availability of essential medications. Results: There was no statistically significant difference in the implementation of refined diabetes management between urban and suburban grassroots medical and health institutions(85.5% vs. 84.5%, P=0.875). The number of medical staff did not differ significantly between the two regions. Among the 133 grassroots medical and health institutions equipped with screening and testing items for diabetes and its complications, three tests had higher rates of availability in urban areas compared to suburban areas: morning urine albumin(87.1% vs. 66.2%, P=0.009), carotid B-ultrasound(91.9% vs. 40.8%, P<0.01), and cardiac function tests(51.6% vs. 29.6%, P=0.016). Regarding the availability of hypoglycemic medications, 12 types of drugs were more commonly available in urban grassroots medical and health institutions than in suburban ones(all P<0.05). Among these, metformin 0.50 g·tablet^-1 was the most commonly used in urban areas. Conclusion: The majority of grassroots medical and health institutions in Nanjing have implemented refined diabetes management, grassroots medical and health institutions could increase investment in screening equipment for diabetes and its complications, as well as expand the availability of hypoglycemic medications.

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