Analysis Of The Follow-up Services Utilization Of Type2Diabetes Mellitus In Rural Areas Based On Anderson Health Services Utilization Model

Research BackgroundDiabetes has become one of the major public health problems in China. The diabeteshealth management and a long-term management mechanism are effective measures for theprevention and control of diabetes. As an important way of controlling diabetes, thefollow-up services can help patients with diabetes to control their disease conditions and toimprove their health status. However, the current studies on diabetes follow-up services, onone hand, are mainly focusing on medical follow-up, and are limited to the urbancommunity. Systematic studies on follow-up of rural public health services are rarely seen.One the other hand, these studies are mainly carried out from the view of the follow-upservice provider, assuming or implying conditions that the supply of follow-up services isthe same as the utilization of follow-up services, namely, however many follow-up servicesthe providers supply, the diabetes patients will make best of these services; whatever kindsof follow-up services the providers supply, the diabetes patients will make full use of theseservices. However, follow-up services or public health services, as quasi-public goods, theirutilization is not entirely consistent with supply, influenced by various factors of bothsupply and demand. So it is necessary to make study on follow-up services from thedemanding view, namely the utilization view. Anderson Health Services Utilization Modelprovides a clear thought for analyzing the follow-up services utilization. This study designstheoretical framework by referencing Anderson Health Services Utilization Model, andsystematically analyzes the follow-up services utilization of type2diabetes mellitus in ruralareas. Research ObjectivesBy taking advantage of Anderson Health Services Model as the analysis framework anda cross-sectional study of type2diabetes mellitus in sample areas, this paper aims topresent the current follow-up services utilization status of type2diabetes mellitus in ruralareas, explore factors that influence the follow-up services utilization, and provideempirical reference for promoting the follow-up service utilization of type2diabetesmellitus. Specific objectives are as follows:(1) To present the environmental factors of rural follow-up service and populationcharacteristics of type2diabetes mellitus, including socioeconomic status, follow-upservices delivery system and so on;(2) To know about the current follow-up services utilization status of rural type2diabetes mellitus: follow-up services utilization frequency, approach, content satisfaction,and follow-up guidance content compliance rate, et al;(3) To explore the influence factors of follow-up services utilization.Research MethodsThis study bases mainly on qualitative analyze. Through the description of the4dimensions, environmental characteristics, population, health behavior and health results ofAnderson Health Services Model, the paper analyzes the current rural follow-up servicesutilization of type2diabetes mellitus. Statistical methods are mainly the absolute number,proportion, etc. Through the single factor analysis, the study explores the interaction ofvarious dimensions, reflecting the follow-up services utilization influencing factors.Statistical methods are mainly to the normal or approximately normal distribution data,using t-test to compare the mean variance of two groups; to unidirectional orderly data,using chi-square test; to bidirectional orderly data, using the trend chi-square test. Bymultiple factor analysis, this study explores the influencing factors of follow-up serviceutilization rate and satisfaction. Statistical methods are mainly adopting2order PQLalgorithm model fitting two levels that does not contain zero variables to determine whetherthe hierarchy problems of data exists. If there is no hierarchy problem, Logistic regressionmodel fits the data with single level, and if hierarchy problem exists, Logistic regression model fits the data with two levels.Main Research Findings(1) Environment DimensionsPatients with type2diabetes as a whole are poor in rural areas, affecting medicationguide service utilization and timely seeking medical service guidance compliance rate;follow-up personnel from different organizations affect the follow-up service utilizationrate and timely seeking medical service guidance compliance rate.(2) Population Characteristics DimensionsThe follow-up service needs of rural type2diabetes mellitus are not fully met; ageinfluences the service of monitoring glucose, and the monitoring rate of the junior group ishigher than that of the senior group; health care consciousness influences the follow-upservice, and the follow-up service utilization and satisfaction of patients with better healthcare consciousness are higher; diabetes patients in more severe conditions tend to use moreguidance services, and their guide adherence rate is higher.(3) Health Behavior DimensionsFollow-up services utilization frequency is affected by follow-up services utilizationdesire and in the higher follow-up services utilization frequency group, the desire to usefollow-up services is stronger; Rural type2diabetes mellitus tend to use the telephonefollow-up and outpatient follow-up; content pertinence of current follow-up serviceutilization is not strong.(4) Health Results DimensionsThe follow-up services utilization rate as a whole is low, affected by taking diabetesdrugs, follow-up services utilization desire, actively consulting diabetes health careknowledge and knowledge about diabetes. Follow-up service utilization satisfaction isaffected by disease course, active consultation of diabetes knowledge with town doctors,follow-up services demand and asked about diabetes complications by doctors duringfollow-up services.