摘要
目的评价自我管理培训指导网络项目与常规糖尿病教育模式的成本与效果。方法将2007年1月至12月东南大学附属中大医院内分泌科收治的196例患者[男114例，女82例，平均年龄（53±10）岁]根据入院时间分为试验组[n=124，男72例，女52例，平均年龄（54±10）岁]和对照组[n=72，男42例，女30例，平均年龄（51±10）岁]。试验组采用自我管理培训指导网络模式，即给予为期5个半天的糖尿病集中培训加后续强化随访（活动、电话、短信、网络等）。对照组采用常规糖尿病教育，给予分次糖尿病教育指导和后续定期随访。于人组时、6、12个月后使用自行编制的调查问卷记录各组患者一般情况、临床观察指标（糖化血红蛋白、血糖、血压、血脂、体质指数）、医疗成本（治疗费、药费、营养保健品费、住院费、康复治疗费）和项目成本，进行2型糖尿病自我管理培训指导网络项目的成本-效果分析。结果与入组时相比，干预后6、12个月试验组和对照组糖化血红蛋白、空腹血糖、餐后血糖显著降低（均P〈0．05）。随访12个月时，试验组空腹血糖（6．1mmol／L）、餐后2h血糖（8．6mmol／L）和糖化血红蛋白（7．1％）均低于对照组（分别为6．2mmol／L、9．1mmol／L、7．6％；均P〈0．05）。在一年的随访周期内，实验组使糖化血红蛋白下降1％、使空腹血糖值、餐后血糖值下降1％所需费用分别233．81元、2911．52元、925．81元，对照组使糖化血红蛋白下降1％所需费用为243．37元，使餐后血糖值下降1％所需费用为959．18元。结论糖尿病自我管理培训指导网络模式在改善2型糖尿病患者血糖控制方面更为经济，优于传统糖尿病教育指导方式。
Objective To evaluate cost effectiveness of a school-based intensive self-management education network. Methods A total of 196 patients with type 2 diabetes mellitus （male 114, female 82, average age （53 ± 10 ） y ） were recruited from a hospital in 2007 and assigned to receive intensive selfmanagement training （treatment group, n = 124, male 72, female 52, average age （54 ± 10 ） y ） or conventional education program （control group, n = 72, male 42, female 30, average age （51 ± 10） y）. The treatment group received diabetes self-management training for 2.5 days and subsequent regular followup （website, telephones, short message, etc）. In the control group, the subjects received diabetes education lecture once a week for 5 times. The changes of metabolic control and medical expenditure were assessed after 6 or 12 months. Cost-effectiveness was assessed at the end of the study. Results Hemoglobin Alc （HbAlc）, fasting blood glucose （FBG） , 2-h blood glucose were significantly decreased in each group at 6 and 12 months （all P 〈0. 05）. At the end of follow-up, PBG （6. 1 mmoL/L）, 2-h blood glucose （8.6 mmoL/L） and HbAlc （7.1%） of the treatment group were lower than the control group （6. 2 mmol/L, 9.1 mmol/L and 7.6% , respectively; all P 〈 0. 05）. During 1-year follow-up, to decrease 1% HbAlc, FBG and 2-h blood glucose cost 233.11, 2911.52 and 925.81 RMB in the treatment group. However, the cost was 243.25 and 959. 18 RMB to decrease 1% HbAlc or 2-h blood glucose in the control group. Conclusion School-based self-management education network may be more effective and economic than conventional education programme in improving glucose control.
出处
《中华糖尿病杂志》
CAS
2012年第9期532-536,共5页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
江苏省卫生厅重大科研项目（K200608）
江苏省科技厅自然科学基金重点项目（BK2010087）
关键词
糖尿病
2型
自我管理
成本-效果分析
Diabetes mellitus, type 2
Self-management
Cost-effectiveness analysis
