县域医疗卫生共同体背景下石河子市慢性病患者共病现状及影响因素分析
Analysis on Current Situation and Influencing Factors of Multimorbidity of Patients with Chronic Diseases in Shihezi City Under the Background of County-level Medical and Health Community
李圆圆 1林陶玉 2蒋雅红 3李烨 4郭薇 1郭晓颖 1闵锐5
作者信息
- 1. 石河子大学医学院,新疆石河子,832002
- 2. 苏州高新区人民医院,江苏苏州,215129
- 3. 第八师石河子市总医院医共体办公室,新疆石河子,832000
- 4. 石河子大学医学院,新疆石河子,832002;中南大学湘雅二医院神经内科监护室,湖南长沙,410012
- 5. 华中科技大学同济医学院公共卫生学院,湖北武汉,430074
- 折叠
摘要
目的:分析石河子市慢性病患者共病现状及影响因素,为县域医疗卫生共同体资源的合理配置和慢性病共病的精准防治提供数据支撑.方法:于 2022 年 8 月采用分层整群抽样方法筛选 50996 例慢性病患者作为研究对象,组间比较采用卡方检验、使用分层模型对慢性病患者共病现状的影响因素进行二分类logistic回归分析、采用网络分析法对共病模式的复杂性进行可视化分析.结果:慢性病患者中,共病患者13801 例(27.1%),女性慢性病患者的共病风险高于男性(OR=1.081,P<0.001);随着年龄的增长,共病风险增加(OR=1.026,P<0.001);病程增加,共病风险降低(OR=0.936,P<0.001);农村慢性病患者的共病风险低于城市(OR=0.891,P<0.001);交互作用发现,随病程的延长,农村慢性病患者的共病风险高于城市(OR=1.124,P<0.001).慢性病患者共病网络中,高血压节点加权度最高,对患其他慢性病的影响力最大;农村慢性病患者共病网络边数多于城市,网络直径小于城市.结论:石河子市慢性病患者共病现状较为严重,年龄、性别和病程是慢性病共病的重要危险因素,农村慢性病患者的共病风险随病程增加而高于城市,共病网络更加复杂.县域医疗卫生共同体内需优化各层级医疗卫生机构的资源结构并进行合理配置,以改善日益严峻的慢性病患者共病的防控形势.
Abstract
Objective:To analyze the current situation and influencing factors of multimorbidity of patients with chronic disea-ses in Shihezi city,so as to provide data support for scientific layout of resources and precise prevention and treatment of chronic multimorbidity in county-level medical and health community.Methods:A stratified cluster sampling method was used to screen 50996 adult patients with chronic diseases as the study population in August 2022,and chi-square tests were used for comparison between groups,binary logistic regression analysis was performed using a stratified model to analyze the influencing factors of chronic disease multimorbidity,and network analysis was used to visualize the complexity of multimorbidity patterns.Results:Among adult patients with chronic diseases,13801 cases(27.1%)had multimorbidity,and the risk of multimorbidity was higher in women with chronic diseases than in men(OR=1.081,P＜0.001).The risk of multimorbidity increased with age(OR=1.026,P＜0.001),the risk of multimorbidity decreased with increasing disease duration(OR=0.936,P＜0.001),the risk of multimorbidity in rural areas was lower than urban areas(OR=0.891,P＜0.001),and the interaction found that the risk of multimorbidity was higher in rural are-as than urban areas with increasing disease duration(OR=1.124,P＜0.001).In the chronic disease multimorbidity network,the weighted degree of hypertension nodes was the highest,and it had the greatest influence on other chronic diseases.The number of comorbidity network edges of rural patients with chronic diseases was more than that of urban patients,and the network diameter was smaller than that of urban patients.Conclusion:The comorbidity status of patients with chronic diseases in Shihezi city is more serious.Age,gender and course of disease are important risk factors for comorbidity of chronic diseases.The risk of comorbidity in rural areas is higher than that in cities with the increase of course of disease,and the comorbidity network is more complex.The county-level medical and health community needs to optimize the resource structure of institutions at all levels and rationally allo-cate them to improve the increasingly severe situation of prevention and control of comorbidities in patients with chronic diseases.
关键词
慢性病管理/共病/影响因素/县域医疗卫生共同体/石河子Key words
Chronic Disease Management/Multimorbidity/Influencing Factor/County-level Medical and Health Communi-ty/Shihezi引用本文复制引用
基金项目
国家自然科学基金(72064033)
中央高校基本科研业务费专项(2020kfyXJJS057)
出版年
2024
NETL
NSTL
万方数据