An Overview of Diabetes Management in China: The Application of Innovative Care for Chronic Conditions Framework 中国糖尿病管理概述:慢性病创新照护模式的应用

Authors

  • Chien-Ching Li US Centers for Disease Control and Prevention

Keywords:

diabetes management, China

Abstract

China has the largest number of people with diabetes in the world. In the past, no overall assessment of diabetes management efforts has been done in China. Today diabetes has become a significant public health problem in China. It is imperative to gain a comprehensive view of diabetes management efforts within China’s specific socio-political infrastructure. In this study, the Innovative Care for Chronic Conditions framework (ICCC) comprised of Macro (policy environment), Meso (health care organization and community), and Micro (patient interaction) levels developed by World Health Organization was used as an analytic framework to demonstrate status and gaps in existing diabetes management in China. An integrative multi-level literature review was conducted using the ICCC framework. Multiple resources, including English and Chinese-language references databases and information from China governmental health websites, were used. Today, responsibilities for diabetes management in China are mainly delegated to health care providers. This effort could be enhanced and complemented by increased support from the government, more resources for diabetes management in the community; structures from health organizations, and stronger partnerships between health care organizations and the community. The roles of patients and their families in diabetes management should also be elevated. Researchers, health practitioners, policy makers and other stakeholders are able to use the findings to delineate optimal strategies for diabetes prevention and management. In the future, the ICCC framework can serve as the conceptual basis for chronic conditions situation analysis and health care system design in China.

References

Ai, Y., & Yang, Z. (2008). The community management of type 2 diabetic patients. Modern Medicine Health(6), 871-872.

An, N., & Deng, Y. (2008). The effect of health education on type 2 diabetic patients Modern Medicine Health, 24(24), 3735-3736.

Association of Diabetic Patients. (2008). Retrieved August 7, 2008, from http://tnb.hongbage.net/auto/data/121223/

Chan, J. C., & Cockram, C. S. (1997). Diabetes in the Chinese population and its implications for health care. Diabetes Care, 20(11), 1785-1790.

Chen, X., Su, J., Liu, H., Guo, X., & Tao, L. (2006). Study of knowledge on diabetes prevention of physicians from county, village and township. Practical Preventive Medicine, 13(1), 98-99.

Chen, Y. (2007). The clinic effect of health education on 260 type 2 diabetic patients. Chinese Journal of Rural Medicine and Pharmacy, 14(4), 70-71.

Chen, Z., Zhao, L., Yin, L., & Lin, H. (2007). Evaluation of the mode of integration of community / hospital management of diabetes patients. Modern Hospital, 7(Supplement), 176-177.

China NSF. (2008). Guideline of application for natural science funding. Retrieved September 5, 2008, from http://www.nsfc.gov.cn/nsfc/cen/xxgk/sqzn.htm

Chinese CDC. (2003). Guideline for Chinese diabetes prevention. Retrieved June 27, 2008, from http://www.chinacdc.net.cn/n272442/n272530/n273736/n273796/n320624/n320634/5769.html

Chinese CDC. (2005). Development of diabetes and complication management system Chinese Journal of Health Education, 21(4), 283.

Chinese CDC. (2006). Personnel Training for Integrative Diabetes Prevention and Control Retrieved March 31, 2009, from http://www.chinacdc.net.cn/n272442/n272530/n273601/n273616/n273661/11456.html

Chinese CDC. (2007). Workshop of comprehensive diabetes and hypertension prevention in community. Retrieved Jun 25, 2008, from http://wsj.bjchy.gov.cn/web/cyjbyf/xwpd/18311.htm

Chinese Nutrition Society. (1999). Dietary guidelines and the Food Guide Pagoda for Chinese residents: balanced diet, rational nutrition, and health promotion. Nutrition Today, 34, 106-115.

Chu, L. (2004). Evaluation of effect about self-administrating intervention education of diabetes mellitus. Journal of Dali College, 3(1).

Coleman, K., Reiter, K. L., & Fulwiler, D. (2007). The impact of pay-for-performance on diabetes care in a large network of community health centers. J Health Care Poor Underserved, 18(4), 966-983.

Cui, F. (2007). Implement community integrated interventions for diabetic patients based on health education. Journal of Chinese Modern Medicine, 4(6), 574-575.

Deng, C. (2008). The effect of health education on type 2 diabetic patients Modern Medicine Health, 24(17), 2660.

Diabetes Friends. (2008). Retrieved August 7, 2008, from http://www.tnbzy.com/

Dong, Z., Sun, C., Ying, Q., & Lou, L. (2008). County and city hospitals in developing diabetes knowledge for patients. Zhejiang Clinical Medical Journal(4), 574-575.

Dongbo, F., Ding, Y., McGowan, P., & Fu, H. (2006). Qualitative evaluation of chronic disease self-management program (CDSMP) in Shanghai. Patient Educ Couns, 61(3), 389-396.

Dongliu BBO. (2006). Diabetes prevention club. Retrieved June 25, 2008, from http://www.dljd.gov.cn/viewsqnews.asp?id=4505

Eggleston, K., Ling, L., Qingyue, M., Lindelow, M., & Wagstaff, A. (2008). Health service delivery in China: a literature review. Health Econ, 17(2), 149-165.

Epping-Jordan, J. E., Pruitt, S. D., Bengoa, R., & Wagner, E. H. (2004). Improving the quality of health care for chronic conditions. Quality and Safety in Health Care, 13(4), 299-305.

Fan, R. (2007). Corrupt practices in chinese medical care: the root in public policies and a call for Confucian-market approach. Kennedy Inst Ethics J, 17(2), 111-131.

Fang, H., & Fang, L. (2006). Application of group management patterns for diabetic patients in county hospital. Journal of Nursing Science, 21(9), 6-7.

Fisher, M., & Kapustin, J. (2007). A Practical Guide for Aggressive Management of Type 2 Diabetes. The Journal for Nurse Practitioners, 3(4), 259-270.

Fu, D., Fu, H., McGowan, P., Shen, Y. E., Zhu, L., Yang, H., et al. (2003). Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial. Bull World Health Organ, 81(3), 174-182.

Gao, Y., Yang, Y., Hu, M., & Gao, Y. (2005). The comparison between diabetes management models in community. Bulletin of Medical Research(10), 52-52.

Ge, K., & McNutt, K. (2000). How the Chinese link dietary advice to their national plan of action for nutrition. Journal of the American Dietetic Association, 100(8), 885-886.

Gu, J. (2001). Study on community management of type 2 diabetes mellitus patients and their results. General Practitioner(4), 154-155.

Gu, Y., Zhao, D., Wang, W., Wang, W., & Cheng, J. (2008). The evaluation of the training effects on knowledge level for diabetes diagnosis and treatment of physicians in districts and community hospitals of Beijing. Chinese Journal of Diabetes, 16(5), 299-301.

He, J., Zhu, L., & Pu, X. (2005). The effect of systematic management for type 2 diabetic patients in Qijiang community. Journal of Community Medicine, 3(3), 1-2.

He, S. (2004). Effect analysis after health education intervention for community diabetes. Journal of Nurses Training, 19(6), 494-495.

He, S., Huang, X., Li, Y., & Li, W. (2009). The provision of club-based health education for pre-diabetics. The Journal of Medical Theory and Practice, 22(4), 466-468.

Health Message. (2006). Guangxi Medical Journal, 28(6), 962-962.

Healthy Outlook. (2009). Nature, 458(7240), 807-808.

Hong, M., Zhong, X., & Wang, L. (2004). The management of outpatients in diabetes clinic and health education. Chinese Medical Journal of Communications(5), 602-602.

Hope Project. (1997). China Diabetes Education Program. Retrieved June 25, 2008, from http://www.hopechina.com/english%20version/BJProject/Diabetic1.htm

Hope Project. (2007). Beijing diabetes care and education to community program. Retrieved June 25, 2008, from http://www.hopechina.com/english%20version/BJProject/BDiabetic1.htm

Hope Project. (2008). Expanding Improving Diabetes Education and Care in China Program. Retrieved June 25, 2008, from http://www.hopechina.com/english%20version/BJProject/EIDiabetic1.htm

Huang, C., Dai, S., Bao, S., Yao, D., Fan, H., Lin, J., et al. (2005). Effects of telephone follow-up intervention on diabetic patients discharged form hospital Guangxi Medical Journal, 27(10), 1625-1626.

Huang, J. (2008). Incentive project of health knowledge dissemination in China. China Medical Herald, 5(17), 1-1.

Huang, J., Sunyan, W., Liu, Y., Zhao, W., & Fu, D. (2007). The evaluation of effects of group management model on diabetes in the countryside. Shahghai Journal of Preventive Medicine, 19(6), 315-316.

IDF. (2009). Diabetes Atlas. Retrieved February 11, 2010, from http://www.diabetesatlas.org/content/urgent-need-prevention-and-management

Li, G., Zhang, P., Wang, J., Gregg, E. W., Yang, W., Gong, Q., et al. (2008). The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet, 371(9626), 1783-1789.

Li, H., Yang, H., & Shen, X. (2006). Current situation and problem of follow-up for diabetic patients in China. Journal of Nursing (China), 13(3), 33-35.

Li, M., Xu, R., & Sun, T. (2009). Implementation of interactive mode of hospital care and community care for diabetic patients. Chinese Nursing Research, 23(6), 1495-1496.

Li, R., Li, X., & Wang, Z. (2002). The feasibility study of application of medical and health file in the screening and management of diabetic patients. Chinese Journal of Public Health Management, 18(3).

Lin, B., Bin, H., & Tao, F. (2006). Effects on community health interventions on diabetic patients. Liuzhou Medicine, 19(4), 218-221.

Lin, J. (2007). The Status and Strategy of the Management of Periodic Follow-up Record for Diabetics. Hebei Medicine, 13(9), 1090-1092.

Lin, J., Li, H., Wang, X., Zhu, Y., & Lin, Y. (2008). The evaluation of health education in diabetes club. Chinese Journal of Nursing, 43(4), 368-370.

Luo, M., & Yu, K. (2006). The analysis of influence of diabetes club on outpatient and hospital. Journal of Practical Diabetology, 2(5), 32.

Miu, J., Zheng, D., & Tao, X. (2008). The establishment of community health file system for diabetes prevention and control. Journal of Practical Medical Techniques, 15(15), 2027-2028.

MOH. (2008). The Dissemination of Diabetes Prevention and Control Knowledge. Retrieved March 31, 2009, from http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/200807/37359.htm

MOH. (2009). Integration of Community and Hospital Health Education Retrieved March 31, 2009, from http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohgjhzs/s3578/200902/39068.htm

NCNCD. (2002). Guideline for diagnosis and treatment in non-communicable chronic disease. Retrieved from http://www.chinancd.com.cn/download/Cri2003527163533.pdf

NCNCD. (2003a). Cooperation with Novo Nordisk pharmaceutical company in diabetes management. Retrieved June 27, 2008, from http://www.chinancd.com.cn/include/viewInfo.asp?id=201

NCNCD. (2003b). National project for diabetes management. Retrieved June 27, 2008, from http://www.chinancd.com.cn/tnb/index.asp

NCNCD. (2007a). First United Nations World Diabetes Day in Beijing-China action. Retrieved March 11, 2009, from http://www.chinancd.com.cn/include/viewInfo.asp?id=1555

NCNCD. (2007b). Working summary of self-management program for chronic disease in Beijing. Retrieved June 27, 2008, from http://www.chinancd.com.cn/include/viewInfo.asp?id=1625

NCNCD. (2008). United Nations World Diabetes Day in Beijing-China action. Retrieved March 11, 2009, from http://www.chinancd.com.cn/include/viewInfo.asp?id=1893

Pan, C. (2005). Diabetes care in China: meeting the challenge. World Hosp Health Serv, 41(3), 29-30, 32.

Rosenthal, M. B., Fernandopulle, R., Song, H. R., & Landon, B. (2004). Paying for quality: providers' incentives for quality improvement. Health Aff (Millwood), 23(2), 127-141.

Sandstrom, S. (2006). Use of case studies to teach diabetes and other chronic illnesses to nursing students. J Nurs Educ, 45(6), 229-232.

Shiyuan BBO. (2008). Diabetes prevention lectures. Retrieved June 25, 2008, from http://www.shiyuan.bjshy.gov.cn/nr.asp?id=952

Shui, M. (2006). The fully start of Bayer Diabetes Houses in China. China Medical News, 21(13), 12.

Song, X., Jin, Q., Wang, X., Wang, L., & Wang, A. (2005). The Exploration of Hospital-Community Integrated Diabetes Prevention Model Chinese Journal of Prevention and Control of Chronic Non-Communicable Diseases, 13(5), 241-242.

Tang, Z., & Qiu, L. (2004). Preliminary observation of community group management for patients with type 2 diabetes. Journal of Community Healthcare(2), 81-83.

Valdez, G. M., Dadich, K. A., Boswell, C., Cannon, S., Irons, B. K., Vickers, P., et al. (2007). Planning and implementing an interdisciplinary diabetes workshop for healthcare professionals. J Contin Educ Nurs, 38(5), 232-237.

Wang, A., Li, Q., Yin, C., Yan, J., Mei, Y., Liu, Y., et al. (2005). The implementation of health education on diabetic patients in community. Community Healthcare, 4(5), 348-349,351.

Wang, T. (2005). The position of local hospital in diabetes prevention and control. Journal of Practical Diabetology, 2(1), 61-64.

Wang, X., Song, X., & Jin, Q. (2005). Tentative exploration on the prevention and cure pattern of diabetes in community. Shanghai Journal of Preventive Medicine, 17(4), 190-191.

Wang, Y. (2008). The effects of health file system on diabetes management. Journal of Clinical Nursing, 23(10), 245.

Wang, Y., & Zhang, H. (2006). Effect analysis of health education of diabetes in hospital. Chinese Journal of the Practical Chinese With Modern Medicine(7), 788-789.

Wei, X., Barnsley, J., Zakus, D., Cockerill, R., Glazier, R., & Sun, X. (2008). Evaluation of a diabetes management program in China demonstrated association of improved continuity of care with clinical outcomes. J Clin Epidemiol, 61(9), 932-939.

Whiting, D. R., Guariguata, L., Weil, C., & Shaw, J. (2011). IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract, 94(3), 311-321.

WHO. (2002). Innovative care for chronic conditions : building blocks for action : global report. [Geneva]: Noncommunicable Diseases and Mental Health, World Health Organization.

Wu, S., You, N., Mi, J., Li, N., Gao, H., & Yiliha, M. (2006). Health education mode of diabetes mellitus and its effectiveness evaluation in Karamay city. Chinese Journal of Health Education, 22(7), 499-501.

Xi, L., & Hu, S. (2005). The problem of diabetes education in local hospitals and its strategy. Attend to Practice and Research, 2(B08), 22-24.

Xiluoyuan BBO. (2007). Quiz competition of diabetes knowledge. Retrieved June 25, 2008, from http://xlyjd.bjft.gov.cn/dtxw/detail.asp?id=34003&type=1

Yan, J., Li, Q., & Wang, A. (2008). The function of volunteer in community diabetes club. Community Healthcare, 7(1), 30-36.

Yang, C. (2008). Influence of family follow-up on therapeutic effect of diabetes mellitus patients. Chinese Nursing Research, 22(11B), 3000.

Yang, L., He, Z., & Lin, S. (2009). The application of club based health education to elderly diabetics. Modem Clinical Nursing, 8(4), 45-46.

You, R., Zhu, H., Zeng, W., & Pan, Q. (2009). Effect of Hospital-community-family-based Behavioral Intervention on Quality of Life of Patient with Type 2 Diabet. Journal of Nursing Science, 24(13), 81-83.

Yu, F., Jin, L., Tai, Y., Zhu, Z., Zhu, W., Huang, J., et al. (2009). The evaluation of effects of group management on community diabetics. Shanghai Journal of Preventive Medicine, 21(5), 230-232.

Yuan, Y., Shen, Q., & Meng, H. (2004). Analysis of effect of health education and its influential factors in community diabetic patient. Shanghai Nursing Journal, 4(5), 13-15.

Zhai, F., Fu, D., Du, S., Ge, K., Chen, C., & Popkin, B. M. (2002). What is China doing in policy-making to push back the negative aspects of the nutrition transition? Public Health Nutr, 5(1A), 269-273.

Zhang, S., Du, X., Qiang, N., Wu, L., & Ding, L. (2005). The preliminary study of type 2 diabetes on community comprehensive prevention and cure. Chinese General Practice(15), 1256-1257.

Zhao, C. (2009). Three-year follow up of thirty cases with type 2 diabetes. Medical Journal of Chinese People’s Health, 21(13), 1606-1607.

Zhao, P., Wang, L., Wang, C., & Cuei, R. (2006). The diabetic education work and management. Chinese Journal of the Practical Chinese With Modern Medicine, 19(2), 177-178.

Zhao, X., Wu, H., Wu, J., Li, H., & Zhang, J. (2007). Study on autogenic control before and after synthetic prevention and treatment for community diabetes. Community Healthcare, 6(5), 354-355.

Zhao, Y., Li, Q., Yan, J., & Wang, A. (2008). The analysis of performance in diabetes self-management based on health promotion club. Chinese Journal of Prevention and Control of Chronic Non-Communicable Diseases, 16(1), 72-73.

Zhou, H., Du, X., Li, Y., Wu, L., Qiang, N., Liang, W., et al. (2004). The evaluation of the treatment effect between colligate management and medical outpatient department for noninsulin diabetics. Chinese General Practice(15), 1067-1069.

Zhou, J., Gao, L., Fong, J., Song, C., & Chen, Y. (2004). Evaluation of the effect on integrated prevention and treatment of diabetes in community. Shanghai Journal of Preventive Medicine, 16(2), 64-66.

Zhou, L. (2007). The effect of community interventions in diabetes. Internal Medicine of China, 2(1), 61-62.

Zhu, B. (2006). The establishment of community diabetes club to implement health education. Modern Nursing, 12(2), 195-196.

Zhu, L., WU, K., Cen, Z., DING, Y., Fu, H., & Fu, D. (2005). Evaluation of effect about self-management intervention in community diabetes. Shanghai Journal of Preventive Medicine, 17(10), 506-507.

Zhu, L., Yu, X., Zhao, D., Xing, H., Huang, C., & Ren, X. (2004). Effects of health education intervention on patients with diabetes mellitus in 20 cities in China. Chinese Journal of Health Education, 20(10), 891-893.

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2014-06-10

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