摘要
目的 了解中国大城市 2型糖尿病 (T2DM )患者的血糖 (PG)和糖化血红蛋白 (HbA1c)及其控制情况 ,以及影响患者医疗费用的因素。 方法 对国内 11个大城市的T2DM患者抽样调查 ,收集其疾病控制和治疗费用数据 ,以及相关的影响因素。调查的 1111例T2DM患者中 ,门诊 6 5 8例 ,住院 4 5 3例 ,采用描述统计的方法分析患者的HbA1c和PG控制情况 ,用多因素模型分析医疗费用的主要影响因素。 结果 6 8%患者的空腹血糖 (FPG)没有得到很好控制 ( >7.0mmol/L) ,4 2 %的HbA1c控制效果不佳 ( >7.5 % )。门诊医疗费用的多因素分析中医院级别 (P <0 .0 0 1)、并发症 (P<0 .0 0 1)和末次空腹静脉血糖控制水平 (P <0 .0 5 )是影响患者就诊费用的主要因素。住院医疗费用多因素分析结果显示 ,住院天数 (P <0 .0 0 1)、医院级别、并发症 (P <0 .0 0 1)、家庭人均收入是影响患者住院费用的主要因素。 结论 中国大城市中 5 0 %左右T2DM患者按照 ( 2 0 0 2年的治疗情况 )PG和HbA1c控制效果不佳 。
Objective To evaluates the control of blood glucose in type 2 diabetes mellitus in large urban cities in China and further analyze the critical factors influencing medical cost Methods The data were collected from a sampling survey of patients with type 2 diabetes from 11 cities, including fasting plasma glucose (FPG) level, HbA1c, direct and indirect medical cost, and relevant contributing factors. Descriptive analysis was used to explore FPG and HbA1c data, the results were presented as percentage of patients with defined level of these parameters. The critical factors contributing to medical cost were analyzed with multifactor regression analysis model. Results Of the 1111 patients with type 2 diabetes mellitus, 296 were outpatients, 815 inpatients. FPG was not adequately controlled in 68% of these patients (>7.0 mmol/L). HbA1c was not adequately controlled in 42% of these patients (>7.5%). Multifactor analysis revealed that the significant factors influencing the medical cost of outpatients were the level of hospitals where patient are seen ( P <0.001), the presence of complications ( P <0.001) and FPG levels ( P <0.05). For inpatients, the medical cost was influenced significantly by days of hospital stay ( P <0.001), level of hospital, complications ( P <0 001) and family income per capita. Conclusion According to the treatment status in the year 2002, about 50% of the surveyed type 2 diabetic patients from large urban cities in China are not adequately controlled in terms of FPG and HbA1c. Complications and inadequate control of FPG (only outpatients) are significant factors contributing to higher medical cost of type 2 diabetes. This is further confirmed by multifactor analysis.
出处
《中国糖尿病杂志》
CAS
CSCD
2004年第3期205-208,共4页
Chinese Journal of Diabetes
