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全科医疗中心血管疾病预防保健的审计

Audit on cardiovascular disease preventive care in general practice.

作者信息

Chan S C, Lee T W, Teoh L C, Abdullah Z C, Xavier G, Sim C K, Ng A C, Ong I C H, Begum R, Leong C C

机构信息

Department of Primary Care, Universiti Kuala Lumpur Royal College of Medicine Perak, 3 Jalan Greentown, Ipoh 30450, Malaysia.

出版信息

Singapore Med J. 2008 Apr;49(4):311-5.

Abstract

INTRODUCTION

Cardiovascular disease is a major cause of morbidity and mortality. Primary care doctors as general practitioners (GPs) play a central role in prevention, as they are in contact with a large number of patients in the community through provision of first contact, comprehensive and continuing care. This study aims to assess the adequacy of cardiovascular disease preventive care in general practice through a medical audit.

METHODS

Nine GPs in Malaysia did a retrospective audit on the records of patients, aged 45 years and above, who attended the clinics in June 2005. The adequacy of cardiovascular disease preventive care was assessed using agreed criteria and standards.

RESULTS

Standards achieved included blood pressure recording (92.4 percent), blood sugar screening (72.7 percent) and attaining the latest blood pressure of equal or less than 140/90 mmHg in hypertensive patients (71.3 percent). Achieved standards ranged from 11.1 percent to 66.7 percent in the maintenance of hypertension and diabetic registries, recording of smoking status, height and weight, screening of lipid profile and attaining target blood sugar levels in diabetics.

CONCLUSIONS

In the nine general practice clinics audited, targets were achieved in three out of ten indicators of cardiovascular preventive care. There were vast differences among individual clinics.

摘要

引言

心血管疾病是发病和死亡的主要原因。基层医疗医生作为全科医生(GPs)在预防工作中发挥着核心作用,因为他们通过提供首诊、全面和持续的护理,与社区中的大量患者有接触。本研究旨在通过医疗审计评估全科医疗中心血管疾病预防护理的充分性。

方法

马来西亚的九名全科医生对2005年6月到诊所就诊的45岁及以上患者的记录进行了回顾性审计。使用商定的标准和规范评估心血管疾病预防护理的充分性。

结果

达到的标准包括血压记录(92.4%)、血糖筛查(72.7%)以及高血压患者最新血压达到或低于140/90 mmHg(71.3%)。在高血压和糖尿病登记管理、吸烟状况记录、身高和体重测量、血脂谱筛查以及糖尿病患者血糖达标方面,达到的标准从11.1%到66.7%不等。

结论

在所审计 的九家全科医疗诊所中,心血管预防护理的十项指标中有三项达到了目标。各诊所之间存在巨大差异。

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