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背景量化新州乡村糖尿病患者加盟保健服务的利用情况,分析利用不足的原因。设计对挂号登记识别出的268例糖尿病患者通过邮件进行自评问卷调查。场所2家乡村全科诊所。参试者做出应答的共117例糖尿病患者。主要结果测量就诊加盟保健服务医疗人员的年度频率。结果去年看糖尿病教育者占患者的40.2%,看营养师占21.4%,看手足医生占47%。然而其中有25%～40%的患者从未利用过任何服务,不利用的理由:未做转诊(35.9%～68.0%)、对需求缺乏认知(40.6%～59.0%)。去年1/3的患者因为认为他们的全科医生提供了类似的服务而根本就没看过糖尿病教育者,而且与城市相比,乡村平均每年看全科医生次数明显要少(5.6)。去年有正式管理计划的患者去看糖尿病教育专家和手足专家的次数是无正式管理计划患者的2倍,看全科医生频次要多2次。结论加盟保健服务利用率并不比都市低,然而多学科服务利用仍然有较大的提升空间。未寻求这些服务的患者或许更希望他们的全科医生以较少的就诊次数起到多重角色的作用,或还缺乏对其他开业者的了解。若局部地区有加盟保健服务,在糖尿病患者管理中注意管理计划的实施及加强对加盟保健开业医生的角色认识或许可以提高服务利用率。
Background Quantifying the utilization of health care services for rural diabetic patients in NSW and analyzing the reasons for its under-utilization. 268 cases of diabetic patients identified by registered registration were surveyed by email. Location 2 village general clinic. A total of 117 patients with diabetes responded to the questionnaire. The main results measure the annual frequency of visits to health-care providers. Results Last year, diabetes educators accounted for 40.2% of patients, nutritionists accounted for 21.4%, 47% of doctors and nurses. However, 25% to 40% of the patients never used any services. The reasons for not using them are as follows: no referral (35.9% ~ 68.0%) and lack of awareness of demand (40.6% ~ 59.0%). Last year, one out of three patients had never seen a diabetes educator because they thought their GP provided a similar service, and the average number of GPs in rural areas was significantly lower (5.6) per year than in cities. Last year, patients with a formal management plan went to see diabetic educators and hand-foot specialists twice as often as patients without formal management plans and twice as frequently as general practitioners. Conclusion The utilization rate of joining healthcare service is not lower than that of metropolitan area, however, there is still much room for improvement in the utilization of multidisciplinary services. Patients who did not seek these services may also prefer their GPs to play multiple roles with fewer visits, or lack of knowledge of other practitioners. If there are affiliate health services in some areas, paying attention to the implementation of management plans in DM management and strengthening the understanding of the roles of participating doctors may improve service utilization.