基于安德森模型的我国3省市糖尿病合并慢性疼痛患者诊疗满意度分析[*]

An Analysis of the Satisfaction with Medical Care among Patients with Diabetes and Chronic Pain in Three Chinese Provinces/Cites Based on the Andersen Model

摘要:

目的:了解我国3省市糖尿病合并慢性疼痛患者诊疗满意度及影响因素。方法:2023年采用多阶段分层抽样,纳入年龄≥45岁、疼痛持续超过3个月的糖尿病患者,通过问卷调查其健康情况和诊疗满意度。计数资料用率表示,采用卡方检验或Fisher精确检验进行单因素分析,多分类有序logistic回归进行满意度影响因素分析。结果:685例调查对象诊疗满意度为53.7%。有无固定医生(OR=6.829,95%CI:4.669-9.990)、家庭人口数(OR=3.215,95%CI:1.012-10.212)、医保支付模式(OR=0.221,95%CI:0.065-0.744)、是否抑郁(OR=0.464,95%CI:0.267-0.806)、疼痛程度(OR=0.287,95%CI:0.121-0.678)及疼痛发作频率(OR=0.552,95%CI:0.333-0.914)是影响诊疗满意度的主要因素。结论:糖尿病合并慢性疼痛患者诊疗满意度较低。需通过多学科协作、心理干预、强化家庭支持与自我管理等综合措施,提升患者满意度,改善医疗体验和生活质量。

Abstract:

Objective: To understand the medical treatment satisfaction and its influencing factors among patients with diabetes and chronic pain in three provinces of China. Methods: In 2023, a multi-stage stratified sampling method was used to recruit 685 patients aged ≥45 years with diabetes and chronic pain lasting over 3 months. A questionnaire survey was conducted to collect information on their health status and treatment satisfaction. Categorical data were expressed as rates, and single-factor analysis was performed using chi-square test or Fisher"s exact test. Multinomial ordered logistic regression was used for the analysis of factors influencing satisfaction. Results: A total of 685 valid samples of patients with diabetes and chronic pain were included, with a treatment satisfaction rate of 53.7%. The results of multinomial ordered logistic regression analysis showed that the main factors influencing treatment satisfaction were the presence of a fixed doctor (OR = 6.829, 95% CI: 4.669 - 9.990), family size (OR = 3.215, 95% CI: 1.012 - 10.212), medical insurance payment model (OR = 0.221, 95% CI: 0.065 - 0.744), depression (OR = 0.464, 95% CI: 0.267 - 0.806), pain intensity (OR = 0.287, 95% CI: 0.121 - 0.678), and pain attack frequency (OR = 0.552, 95% CI: 0.333 - 0.914). Conclusion:? The treatment satisfaction of patients with diabetes and chronic pain is relatively low. It is essential to enhance multidisciplinary comprehensive treatment, pay attention to patients" psychological status, and strengthen family support and self-management as non-pharmacological treatment measures, in order to improve patients" treatment satisfaction and enhance their medical experience and quality of life.