Study On Influential Factors Of Distribution Of Clinical Visit For Hyperpietic And Diabetic In Shenzhen

Objective: To understand influential factors of distribution of clinical visit for hyperpietic and diabetic in Shenzhen. So that we can provide the theoretical foudation to carry out the basic community public health services for the hyperpietic and diabetic in Shenzhen . Therefore, the community health services can improve their capacity of managing chronic disease; and the patients can make better use of community resources in Shenzhen.Methods: A stratified random sampling method were conducted. 663 hypertensive patients and diabetes in Shenzhen Hospital and community health service centers had been surveyed with the questionnaire about the influential factors of distribution of clinical visit for hyperpietic and diabetic . The basic information about managing chronic disease of 98 community health service centers were collected.128 related doctors were tested and surve -yed of about their ability to manage chronic disease. Then we analyzed the administration level and the influential factors of distribution of clinical visit for hyperpietic and diabetic. We use Epidata3.1 building a database and statistical software SAS9.0 and Stata 11.0 was used for statistical analysis.Results: 663 people were in our survey; men accounted for 46.8%, female for 53.2%; the mean age was 61.46±14.26 years old. Hypertension and diabetes were mainly in the group over 40 years old, particularly between the age of 60 to 69. Hospital visit rate was 38.90%; CHS attendance rate was 61.10%. Patients who tend to hospital for treatment accounted for 42.99%, to CHS for 38.46%, and to both for 18.55%. The influential factors including age, gender, occupations, education, marital status,medical insurance, income, type of disease, the duration of hypertension, blood pressure and blood sugar measuring frequency, the number of complications , the time to the CHS, the cogniti -on about community management and so on(older patients, women, farmers, housewives, retirees ,patients who had low educational level, divorced, widowed, Medicare patients, high blood pressure, no complications, tend to a high proportion of CHS).On the aspect of chronic disease management capability, the average number of chronic disease doctors per ten thousand people was 1.63; the ratio of excellent medical skills for the chronic disease doctors was 13.48%, urban areas higher than rural areas. Multivariate analysis showed that personal characteristics of patients with higher probability of selection CHS were: women, aging, health care, and patients only with high blood pressure; and patients in the commun -ities with more chronic disease physicians, for the doctors will guide the patient in their selection for treatment. According to the regression coefficient, among various influential factors, community health service capability affect the most,while among the personal characteristics, the grestest impact is the health care.Conclusion: At present, 61.10% patients of chronic disease will choose community health service centers, but it still fall far short of the goal of basic medical distribution to community health service centers. Besides, the community health service centers now cannot fully meet the medical needs of community residents, therefore, the capability to serve chronic disease needs to be further strengthened. The distribution of clinical visit of community residents is affected by personal characteristics, the trait of disease and health care providers. Among them, the health care coverage and the capacity of community health service are the most important factors.