Krein S L, Klamerus M L
Department of Veterans Affairs, Center for Practice Management & Outcomes Research, VA Ann Arbor Healthcare System, Michigan 48113, USA.
J Community Health. 2000 Dec;25(6):495-511. doi: 10.1023/a:1005148831739.
This study describes a statewide public health approach to strengthen diabetes care; evaluates diabetes-related processes of care for individuals enrolled in the Michigan Diabetes Outreach Network (MDON) program; and, examines MDON in the context of priorities for diabetes care and public health policy. Organizational information was obtained through semi-structured interviews. Program outcomes are examined using data from client intake and follow-up assessment forms. We report percentages and mean values overall and across networks. Logistic regression is used to identify factors associated with clients receiving recommended diabetes care. Within two years, five of the networks recruited 125 providers and collected information on over 8,000 individuals with diabetes. The percentage of enrollees with a glycosylated hemoglobin measure, eye exam, and dietician visit is greater at follow-up than at intake and an intake "referral" is strongly associated with clients being trieated for high blood pressure at follow-up. The MDON model is a promising public health approach for improving diabetes care but it is necessary to identify program elements that are most effective.
本研究描述了一种全州范围内加强糖尿病护理的公共卫生方法；评估了参与密歇根糖尿病外展网络（MDON）项目的个体的糖尿病相关护理流程；并在糖尿病护理优先事项和公共卫生政策的背景下审视了MDON。通过半结构化访谈获取组织信息。使用来自客户入院和随访评估表的数据来检查项目成果。我们报告总体以及各网络的百分比和平均值。使用逻辑回归来确定与接受推荐糖尿病护理的客户相关的因素。在两年内，五个网络招募了125名提供者，并收集了8000多名糖尿病患者的信息。随访时糖化血红蛋白测量、眼科检查和营养师就诊的参保者百分比高于入院时，并且入院时的“转诊”与随访时接受高血压治疗的客户密切相关。MDON模式是一种有前景的改善糖尿病护理的公共卫生方法，但有必要确定最有效的项目要素。
