McKnight J A, Morris A D, Cline D, Peden N, Fischbacher C, Wild S
University of Edinburgh, Western General Hospital, Edinburgh, UK.
Diabet Med. 2008 Jun;25(6):743-6. doi: 10.1111/j.1464-5491.2008.02453.x.
To create a standardized systematic quality assurance system for diabetes care throughout Scotland.
Each of 15 National Health Service (NHS) boards have submitted core diabetes data for a nationally agreed data specification on an annual basis since 2001. These data are collated to produce an annual national report. We describe the iterative progress of the work in obtaining and analysing this information. The setting was Scotland, with a population of 5 million.
In Scotland in 2006, 196,801 people (3.9% of the population) were reported as having diabetes compared with 105,777 in 2001. In 2006 the prevalence of reported diabetes varied from 3.5 to 4.4% in different NHS board areas, reflecting variation in completeness of local registers as well as different demographic patterns. The completeness of recording of many clinical parameters has also increased. (2002 data n = 103,755: diagnosis date 77%, HbA(1c), blood pressure and cholesterol within 15 months 71, 67 and 60%, respectively, increasing to 98, 87, 89 and 85% by 2006, n = 196,801.) A national information management and technology solution (Scottish Collaborative Information-Diabetes Care), involving automatic daily collection of data from routinely used systems both in primary and secondary care, is now used to co-ordinate the collection of data in all NHS board areas.
We have used routine data to estimate the prevalence of reported diabetes in Scotland, UK. This iterative approach to quality improvement has taken 6 years to achieve a baseline measure of care. There is potential to analyse these data further for a better understanding of the epidemiology of diabetes in Scotland. The national diabetes information technology system will contribute to this process.
为苏格兰全境的糖尿病护理建立一个标准化的系统质量保证体系。
自2001年以来，15个国民保健服务（NHS）委员会每年都按照全国统一的数据规范提交核心糖尿病数据。这些数据经过整理后生成年度全国报告。我们描述了获取和分析这些信息工作的迭代进展情况。研究背景为苏格兰，人口500万。
2006年，苏格兰报告有糖尿病的人数为196,801人（占人口的3.9%），而2001年为105,777人。2006年，不同NHS委员会地区报告的糖尿病患病率在3.5%至4.4%之间，这反映了当地登记的完整性差异以及不同的人口模式。许多临床参数的记录完整性也有所提高。（2002年数据n = 103,755：诊断日期记录完整率为77%，糖化血红蛋白（HbA₁c）、血压和胆固醇在15个月内记录完整率分别为71%、67%和60%，到2006年（n = 196,801）分别增至98%、87%、89%和85%。）一种国家信息管理和技术解决方案（苏格兰协作信息 - 糖尿病护理），涉及从初级和二级护理中常规使用的系统自动每日收集数据，现在用于协调所有NHS委员会地区的数据收集工作。
我们利用常规数据估算了英国苏格兰地区报告的糖尿病患病率。这种质量改进的迭代方法花了6年时间才实现护理的基线测量。有进一步分析这些数据以更好地了解苏格兰糖尿病流行病学的潜力。国家糖尿病信息技术系统将有助于这一进程。
