各級醫院糖尿病慢性合併症住院現況探討

Comparison in Diabetes-Related Complications for Inpatients Among University Medical Centers, Regional Hospitals and District Hospitals

魏榮男(Jung-Nan Wei) ； 宋鴻樟(Fung-Chang Sung) ； 林瑞雄(Chien-Wen Chou) ； 李中一(Chung-Yi Li) ； 莊明雄(Ming-Sion Tsuang) ； 王博仁(Po-Jen Wang) ； 周劍文(Chien-Wen Chou) ； 童瑞年(Jai-Nien Tung) ； 莊立民(Lee-Ming Chuang)

《台灣公共衛生雜誌》 21卷2期 (2002/04) Pp. 115-122

https://doi.org/10.6288/TJPH2002-21-02-04

摘要

目標：比較國內各級醫院糖尿病慢性合併症住院現況，並探討患者的居家自我照護行為。方法：以民國89年6月1日至90年5月31日期間因糖尿病慢性合併症住院的病患為對象，依據北中南分佈分層隨機抽樣，從醫學中心、區域醫院與地區醫院三個層級分別抽出4、3與6家醫院，抽出168、150與138名住院病人。以問卷訪視收集人口、醫療行為資料，並自病人病歷抄錄合併症、醫療檢測及住院資料。結果：各級醫院糖尿病人過去幾年平均住院約4次，腦血管病變比率（介於18.9~28.1%），心血管疾病（介於49.2~55.1%）和腎臟病變（介於43.8~57.4%）之比率，均無明顯統計差異。下肢血管病變（介於7.4~16.2%）和神經病變（介於14.2~33.5%）之比率均以醫學中心的最高，視網膜病變（介於29.7~46.0%）則以區域醫院的住院病人比率最高。定期追蹤率以地區醫院為最低，只有66.4%，各級醫院病人沒有自我監測血糖的有40.8~77.3%，也以地區醫院為最高。結論：糖尿病住院患者大多有多種合併症，重複住院的比率相當高，各級醫院對住院患者遵照醫囑與日常自我照護行為的衛生教育都有很大的改善空間。（台灣衛誌 2002；21（2）：115-122）

關鍵字

糖尿病 ； 住院 ； 慢性合併症 ； 治療效果 ； 自我照護行為

並列摘要

Objectives: The purpose of this study was to investigate and compare the rate of chronic complications for diabetic inpatients among three levels of medical facilities. Diabetic care and patients' self-homecare behaviors were also investigated. Methods: A total of 456 inpatients with diabetes mellitus were recruited from 4 university medical centers (UMC), 3 regional hospitals (RH) and 6 district hospitals (DH) in Taiwan, during June 2000 and May 2001. Patients were interviewed for information in demographic characteristics and health care behaviors. Medical records were reviewed for diabetic care provided to patients and diabetes-related complications diagnosed for them. Results: Patients have been hospitalized for approximately 4 events in average. No significant difference was found in the rates of cardiovascular disease (49.2%-55.1 %), nephropathy (43.8%-57.4%) and cerebrovascular disease (18.9-28.1%) for hospitalized patients, among the 3 levels of hospital. While the UMC inpatients had the highest prevalence rates of diabetic foot (16.2%) and neurophathy (33.5%), the RH inpatients had the highest rate of retinopathy (46. 0%). The rate of regular follow-up check was the lowest (66.4%) for inpatients of DR. They were also less likely than patients of UMC and RH to have self-monitoring of plasma sugar or urine sugar. Conclusions: A good proportion of diabetes inpatients have multiple diabetes-related complications with frequent hospitalizations. Patients cared at DH need greater attention in diabetic care than that at UMC and RH. Standard diabetes care protocol for complication prevention should be implemented.(Taiwan J Public Health. 2002;21(2):115-122)

並列關鍵字

diabetes mellitus ； inpatient ； chronic complication ； treatment effectiveness ； self-care behavior

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