Measuring clinical performance and outcomes from diabetes information systems: an observational study.

作者: J. P. New , S. Hollis , F. Campbell , D. McDowell , E. Burns

DOI: 10.1007/S001250051458

关键词: Cohort studyLogistic regressionPopulationCare provisionGeneralized estimating equationMedicineShared careBlood pressureDiabetes mellitusPediatrics

摘要: Aims/hypothesis. To examine changes in diabetes care provision after the introduction of a district information system.¶Methods. All patients with registered on system between 1993 and 1998 (n = 6544) were included analysis. Drop-out cohort analysis was used to handle population changes, logistic regression models general estimating equations clinical performance over time.¶Results. After system, processes improved appreciably, both primary secondary care. The proportion receiving preventative review within calendar year rose from 56 % 67 1998. these whom each process completed all categories 1998: blood pressure 96 98 %; glycaemic check 93 lipid 31 68 renal 46 87 fundoscopy 79 92 foot screen %. Similarly there an increase achieving intermediate outcome treatment targets (HbA1 c≤ 9.0 29 43 cholesterol ≤ 5.5 mmol/l 5 19 160/90 37 %).¶Conclusion/interpretation. Our results suggest appreciable improvements These apply entire across shared We believe that could, part, be attributable way which has facilitated structured cascade [Diabetologia (2000) 43: 836–843]

参考文章(11)
A D Oxman, R B Haynes, M A Thomson, D A Davis, No magic bullets: a systematic review of 102 trials of interventions to improve professional practice Canadian Medical Association Journal. ,vol. 153, pp. 1423- 1431 ,(1995)
Scott L. Zeger, Kung-Yee Liang, Longitudinal data analysis for discrete and continuous outcomes. Biometrics. ,vol. 42, pp. 121- 130 ,(1986) , 10.2307/2531248
B Jarman, Identification of underprivileged areas BMJ. ,vol. 286, pp. 1705- 1709 ,(1983) , 10.1136/BMJ.286.6379.1705
C.J. Currie, D. Kraus, C.Ll. Morgan, L. Gill, N.C.H. Stott, J.R. Peters, NHS acute sector expenditure for diabetes: the present, future, and excess in-patient cost of care. Diabetic Medicine. ,vol. 14, pp. 686- 692 ,(1997) , 10.1002/(SICI)1096-9136(199708)14:8<686::AID-DIA434>3.0.CO;2-D
NJ Vaughan, PD Home, for the Diabetes Audit Working Group of the Research Unit of the Royal College of Physicians and British Diabetic Association, The UK Diabetes Dataset: a Standard for Information Exchange Diabetic Medicine. ,vol. 12, pp. 717- 722 ,(1995) , 10.1111/J.1464-5491.1995.TB00576.X
Greenhalgh Pm, Shared care for diabetes: a systematic review Occasional paper (Royal College of General Practitioners). ,(1994)