Wilson Charlton, Gilliland Susan, Cullen Theresa, Moore Kelly, Roubideaux Yvette, Valdez Lorraine, Vanderwagen William, Acton Kelly
Indian Health Service, Phoenix Indian Medical Center, 4212 N 16th St, Phoenix, AZ 85016, USA.
Am J Public Health. 2005 Sep;95(9):1518-22. doi: 10.2105/AJPH.2004.053710. Epub 2005 Jul 28.
We reviewed changes in blood glucose, blood pressure, and cholesterol levels among American Indians and Alaska Natives between 1995 and 2001 to estimate the quality of diabetes care in the Indian Health Service (IHS) health care delivery system.
We conducted a cross-sectional analysis of data from the Indian Health Service Diabetes Care and Outcomes Audit.
Adjusted mean Hemoglobin A1c (HbA1c) levels (7.9% vs 8.9%) and mean diastolic blood pressure levels (76 vs 79 mm Hg) were lower in 2001 than in 1995, respectively. A similar pattern was observed for mean total cholesterol (193 vs 208 mg/dL) and triglyceride (235 vs 257 mg/dL) levels in 2001 and 1995, respectively.
We identified changes in intermediate clinical outcomes over the period from 1995 to 2001 that may reflect the global impact of increased resource allocation and improvements in processes on the quality of diabetes care, and we describe the results that may be achieved when community, health program, and congressional initiatives focus on common goals.
我们回顾了1995年至2001年间美国印第安人和阿拉斯加原住民的血糖、血压和胆固醇水平变化，以评估印第安卫生服务局（IHS）医疗服务系统中糖尿病护理的质量。
我们对印第安卫生服务局糖尿病护理与结果审计的数据进行了横断面分析。
2001年调整后的平均糖化血红蛋白（HbA1c）水平（7.9%对8.9%）和平均舒张压水平（76对79毫米汞柱）分别低于1995年。2001年和1995年的平均总胆固醇（193对208毫克/分升）和甘油三酯（235对257毫克/分升）水平也观察到类似模式。
我们确定了1995年至2001年期间中间临床结果的变化，这可能反映了资源分配增加和流程改进对糖尿病护理质量的总体影响，并且我们描述了社区、健康项目和国会倡议关注共同目标时可能取得的结果。
