在糖尿病患病率高的县里,透析比患者教育更容易获得
Janice C Probst1,2, Nicholas Yell1, Gabriel A Benavidez3
1Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia.
Preventing chronic disease
|August 15, 2024
概括
糖尿病自我管理教育和支持 (DSMES) 在高风险地区较少. 在这些社区改善对DSMES的获取可能有助于降低末期病 (ESRD) 的流行率.
科学领域:
- 公共卫生 公共卫生
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
背景情况:
- 控制不良的糖尿病是末期病 (ESRD) 的主要原因,占新病例的44%.
- 糖尿病自我管理教育和支持 (DSMES) 已被证明可以减轻不良结果,包括ESRD.
- 改善糖尿病管理可能会降低ESRD的患病率.
研究的目的:
- 根据糖尿病患病率,比较美国各县的DSMES和透析设施的可用性.
- 在糖尿病流行率高的地区发现DSMES接入的差异.
主要方法:
- 截至2022年11月,收集了有关DSMES计划和ESRD透析设施的县级数据.
- 来自CDC PLACES 2019的糖尿病患病率数据 (≥14.4%的成人患病率) 用于对县进行分类.
- 在2023年进行了分析,以根据糖尿病患病率来比较服务可用性.
主要成果:
- 在所有县的41.0%中,DSMES可用,但在患糖尿病率高的县只有20.7%,而在患糖尿病率低的县只有47.9%.
- 透析设施更为普遍,在所有县的59.2%存在,包括52.8%的高发病率糖尿病县.
- DSMES的可用性与医院的存在有很强的相关性;只有6.3%的没有医院的县提供DSMES.
结论:
- DSMES是减少ESRD患病率的关键干预措施.
- 公共卫生专业人员必须解决DSMES可用性的差异,特别是在高流行率地区.
- 需要建立合作伙伴关系,在服务不足,高风险的社区扩大DSMES服务.
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