糖尿病基层规范性管理质量调查

Background  The incidence of diabetes has been increasing year by yearand the management of type 2 diabetes has been included into the basic community health services as an important disease in China. Howeverat presentthere is still a gap in the standard management of diabetes at the grass-roots levelespecially in quality and ability. Objective  To understand the current situation of diabetes management in Shanghai community health institutions and conduct systematic quality evaluationand to put forward corresponding optimization suggestions for existing problems. Methods  The research was conducted in May 2022and the target population included1community health service centresall community health service centres in 16 administrative districts of Shanghaiwith a total of 249 institutionsand2community general practitioners3 875 community general practitioners were selected by simple random sampling according to the proportion of 50% of the registered population. The questionnaire for medical institutions and the questionnaire for GPs were designed to investigate the implementation of diabetes management in community health centres and the implementation of standardized diagnosis and management of diabetes by community GPs. Results  HbA1c test was available in all community health institutions in Shanghaibut the screening program for diabetes complications was insufficientand only 16.9% of community health service centercould test nerve conduction velocity. The types of oral hypoglycemic agents are relatively completebut the types of insulin are singleand only 7.6% of community health service center are equipped with the new hypoglycemic drug GLP-1receptor agonist. 57.4% of community health service center have set up diabetes clinics. Community general practitioners have a high degree of recognition for the standardized management of diabetes and have a good grasp of the guidelines for the basic management of diabetesbut they have a poor grasp of the basic knowledge of diabetestreatment drugsand the correct rate of the application knowledge of oral hypoglycemic drugs and insulin is only 27.9% and 29.0%. When the blood sugar of newly diagnosed diabetic patients is high and the diagnosis of diabetic nephropathy is confirmedthe community general practitioners are more inclined to refer the patients directly to the superior hospital specialty. Conclusion  The results of this survey showed that the infrastructureequipment and drugs of diabetes management service in Shanghai community health service center have basically met the quality requirementsGaps in knowledge of drug useIt is necessary to further improve the diabetes management quality and medical capacity of primary medical and health institutions by increasing the examination and testing items related to the screening of diabetes complicationsincreasing the types of new hypoglycemic drugs and insulinstrengthening the construction of diabetes specialized clinicsimproving the diagnosis and treatment level of general practitionersand standardizing the diagnosis and treatment behaviors of general practitioners.