在糖尿病发病率高的县,透析比患者教育更容易获得。

IF 4.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Preventing Chronic Disease Pub Date : 2024-08-15 DOI:10.5888/pcd21.240052
Janice C Probst, Nicholas Yell, Gabriel A Benavidez, Mary Katherine McNatt, Teri Browne, Laura Herbert, Whitney E Zahnd, Elizabeth Crouch
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引用次数: 0

摘要

导言:糖尿病控制不佳是导致终末期肾病(ESRD)的主要原因,估计占新病例的 44%。据记载,糖尿病自我管理教育和支持(DSMES)可减少ESRD等不良后果。帮助患者更好地控制病情可最终降低 ESRD 的发病率:我们比较了截至 2022 年 11 月县级 DSMES 和透析的可用性,并根据 18 岁或以上居民的糖尿病估计患病率进行了分类。DSMES 计划和 ESRD 透析设施的位置信息来自 2 个专业组织和医疗保险与医疗服务中心。糖尿病患病率估计值来自美国疾病控制和预防中心的 PLACES 数据集。如果各县在 2019 年的糖尿病患病率位于前四分之一(≥14.4% 的成年人),则被视为糖尿病患病率高的县。分析于 2023 年进行:41.0%的县有DSMES,但糖尿病高发县只有20.7%有DSMES,而糖尿病低发县有47.9%有DSMES。59.2%的县有透析设施,52.8%的糖尿病高发县有透析设施,61.4%的其他县有透析设施。DSMES的提供与县内是否有医院有关,只有6.3%的县没有医院提供该服务:意义:DSMES 可在降低 ESRD 患病率方面发挥作用。公共卫生专业人员需要了解当地提供这项服务的不同水平,并努力发展合作关系,以便在目前尚未提供服务的高患病率地区提供 DSMES。
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Dialysis More Available Than Patient Education in Counties With High Diabetes Prevalence.

Introduction: Poorly controlled diabetes is a principal cause of end stage renal disease (ESRD), generating an estimated 44% of new cases. Diabetes self-management education and support (DSMES) has been documented to reduce adverse outcomes such as ESRD. Helping patients better manage their condition could ultimately reduce ESRD prevalence.

Methods: We compared the county-level availability of DSMES and dialysis as of November 2022 sorted by the estimated prevalence of diabetes among residents aged 18 years or older. The locations of DSMES programs and ESRD dialysis facilities were obtained from 2 professional organizations and the Centers for Medicare & Medicade Services. Estimated diabetes prevalence was obtained from the Centers for Disease Control and Prevention's PLACES data set. Counties were considered to have high diabetes prevalence if they fell into the top quartile for diabetes prevalence in 2019 (≥14.4% of adults). Analyses were conducted in 2023.

Results: DSMES was available in 41.0% of counties but in only 20.7% of counties with high diabetes prevalence versus 47.9% of low prevalence counties. Dialysis facilities were present in 59.2% of all counties, in 52.8% of all high diabetes prevalence counties, and in 61.4% of other counties. DSMES availability was linked to the presence of a hospital in the county, with only 6.3% of counties without a hospital offering the service.

Implications: DSMES could play a role in reducing the prevalence of ESRD. Public health professionals need to be aware of the differing levels of local availability of this service and work to develop partnerships to provide DSMES in high-prevalence areas not currently served.

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来源期刊
Preventing Chronic Disease
Preventing Chronic Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.70
自引率
3.60%
发文量
74
期刊介绍: Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. The mission of PCD is to promote the open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention. The vision of PCD is to be the premier forum where practitioners and policy makers inform research and researchers help practitioners and policy makers more effectively improve the health of the population. Articles focus on preventing and controlling chronic diseases and conditions, promoting health, and examining the biological, behavioral, physical, and social determinants of health and their impact on quality of life, morbidity, and mortality across the life span.
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