Effect of National Basic Public Health Service Utilization on regular medication behavior and glycemic control in type 2 diabetes mellitus / 公共卫生与预防医学

ABSTRACT

Objective To explore the effect of the utilization of National Basic Public Health Service (NBPHS) on the regular medication behavior and glycemic control of patients aged 35 and over with type 2 diabetes, and to provide support for the health management practice of type 2 diabetes patients in China. Methods Based on the multi-stage stratified sampling method, a questionnaire survey was conducted in 10 community health service centers or township health centers in Zhejiang Province, Shanxi Province and Chongqing City in China from November to December 2019. The data of socio-demographic characteristics, utilization of NBPHS in the last year, regular medication in the last six months and glycemic control were collected. The effect of NBPHS utilization on the regular medication rate and glycemic control rate of type 2 diabetes patients was analyzed by logistic regression. Sensitivity analysis was carried out using the multilevel logistic method and the total score calculation method for basic public health services in different countries. Results A total of 1 527 patients with type 2 diabetes aged 35 and over were recruited, 41.00% were male, 66.08% were aged 65 years old and above, and 39.64% were ill for 10 years and over. The survey showed that the regular medication rate was 89.26%, the glycemic control rate was 65.23%, and the score on utilization of NBPHS was 11.83±2.246 (range 0-15). With the more utilization of NBPHS, regular medication rate in patients with type 2 diabetes increased (χ2trend=4.816, P2trend=0.080, P>0.05). The multivariate regression analysis showed that secondary school and above (OR=2.20), longer duration of disease (OR5-9 years=1.62, OR10 year and above=3.92) and higher utilization score of NBPHS (ORQ3=2.01) were protective factors for the regular medication. Compared with the local household registration population, the local resident population (OR=0.54) was a risk factor for regular medication. Unmarried or divorced or widowed (OR=0.61) and longer course of disease (OR10 year and above=0.60) were risk factors for satisfactory glycemic control, while increased monthly income per household (OR2000-5000 yuan=1.52, ORMore than 5000 yuan=1.76) was a protective factor for satisfactory glycemic control. Conclusion The utilization of NBPHS has promoted the regular medication rate of patients with type 2 diabetes, and the higher utilization takes better effect. Emphasis should be paid on patients with low education level, non-local household registration, short course of disease, and no partner. At the same time, it is necessary to strengthen the utilization of NBPHS to promote the change of their health awareness and health behavior..