Jin Andrew J, Martin David, Maberley David, Dawson Keith G, Seccombe David W, Beattie Joyce
Int J Circumpolar Health. 2004;63 Suppl 2:124-8. doi: 10.3402/ijch.v63i0.17871.
In British Columbia, Aboriginal diabetes prevalence, hospitalization and mortality rates are all more than twice as high as in the rest of the population. We describe and evaluate a program to improve access to diabetes care for Aboriginal people in northern communities.
Cost-effectiveness evaluation.
A diabetes nurse educator and an ophthalmic technician travel to Aboriginal reserves, offering people with diabetes services recommended in current clinical practice guidelines: retinopathy screening by digital retinal fundus photography, glaucoma screening by tonometry, point-of-care urine and blood testing to detect microalbuminuria and dyslipidemia and to measure glycated hemoglobin, foot examinations and foot care advice, blood pressure and height and weight measurement and diabetes care advice. Via electronic communication, an ophthalmologist and an endocrinologist in Vancouver review the findings and supervise the mobile clinic staff.
During the first year, 25 clinics were held at 22 sites, examining 339 clients with diabetes. Exit surveys showed high levels of client satisfaction. Mean cost per client (Cdn dollars 1,231) was less than for the alternative, transporting clients to care in the nearest cities (Cdn dollars 1,437).
The mobile clinic is cost-effective and improves access to the recommended standard of diabetes care.
在不列颠哥伦比亚省，原住民糖尿病患病率、住院率和死亡率均是其他人群的两倍多。我们描述并评估了一项旨在改善北部社区原住民糖尿病护理可及性的项目。
成本效益评估。
一名糖尿病护理教育工作者和一名眼科技术员前往原住民保留地，为糖尿病患者提供当前临床实践指南中推荐的服务：通过数字视网膜眼底摄影进行视网膜病变筛查、通过眼压测量进行青光眼筛查、即时检测尿液和血液以检测微量白蛋白尿和血脂异常并测量糖化血红蛋白、足部检查和足部护理建议、测量血压、身高和体重以及提供糖尿病护理建议。通过电子通讯，温哥华的一名眼科医生和一名内分泌学家审查检查结果并监督流动诊所工作人员。
在第一年，在22个地点举办了25场诊所活动，为339名糖尿病患者进行了检查。出院调查显示患者满意度很高。每位患者的平均成本（1231加元）低于另一种选择，即将患者送往最近城市接受治疗的成本（1437加元）。
流动诊所具有成本效益，且改善了获得推荐的糖尿病护理标准的机会。
