Investigation of Utilization Behaviors and Influential Factors in the Integration of Medical and Preventive Care for Diabetic Patients in Shandong Province postprint

Abstract: Background  With the development of the economy and society，the prevalence of diabetes has been increasing year by year. Diabetic patients require not only treatment services but also comprehensive and continuous integration of medical and preventive care. However，due to the fragmentation of "medical-preventive" services，there are certain deficiencies in the utilization of integration of medical and preventive care for diabetic patients. Therefore，improving the utilization of these services is crucial. Objective  To understand the current status and influencing factors of the utilization of integration of medical and preventive care among diabetic patients in Shandong Province，and to provide references for further improving related policies and practices. Methods  In August 2023，a multi-stage stratified cluster random sampling method was used. Based on geographical location and economic development status，Yantai City，Weifang City，and Liaocheng City were selected from the eastern，central，and western regions of Shandong Province，respectively. One county/county-level city was chosen from each city as the sample area. Then，four townships were randomly selected from each county/city. Two villages were randomly selected from each township，and 25 diabetic patients managed by basic public health services were randomly selected from each village to conduct a questionnaire survey. Multivariate binary logistic regression analysis was used to explore the influencing factors of the utilization behavior. Results  A total of 602 patients were surveyed，and 600 valid questionnaires were collected，with a validity rate of 99.67%. The good utilization rate of integration of medical and preventive care among diabetic patients was 54.5%（327/600）.There were statistically significant differences in the utilization of these services among patients with different education levels，living conditions，awareness of integration of medical and preventive care，health beliefs，family doctor contracting status，presence of other chronic diseases，and self-rated health status（P<0.05）. Multivariate binary logistic regression analysis showed that patients with junior high school education（OR=1.896），good awareness of integration of medical and preventive care（OR=5.818），good health beliefs（OR=2.701），and those who had contracted a family doctor（OR=2.106）had better utilization behavior integration of medical and preventive care（P<0.05）. Conclusion  At present，there is still significant room for improvement in the utilization of integration of medical and preventive care among diabetic patients in Shandong Province. Efforts should be made to further improve these services，improving the quality of family doctor services，and increase the publicity of integration of medical and preventive care and related policies.