Rossi Maria C E, Nicolucci Antonio, Arcangeli Adolfo, Cimino Antonino, De Bigontina Gualtiero, Giorda Carlo, Meloncelli Illidio, Pellegrini Fabio, Valentini Umberto, Vespasiani Giacomo
Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S Maria Imbaro CH, Italy.
Diabetes Care. 2008 Nov;31(11):2166-8. doi: 10.2337/dc08-0469. Epub 2008 Aug 11.
To describe patterns of diabetes care and implement benchmarking activities at the national level.
A total of 86 clinics participated, all using electronic medical records. Quality indicators were identified, and software was developed, enabling the extraction of the information needed for quality-of-care profiling.
Overall, 114,249 patients with type 2 diabetes were seen during 2004. A1C was measured at least once in 88.0% of the patients, lipid profile in 64.6%, blood pressure in 77.2%, and microalbuminuria in 48.1%. Overall, 43.1% of individuals had A1C <or=7.0%, 36.6% had blood pressure <or=130/85 mmHg, and 29.8% had LDL cholesterol <100 mg/dl. Only 5.5% of the patients had achieved all the favorable outcomes. Wide between-center variation was documented for all indicators.
This study is the first step of a nationwide quality-improvement effort and documents the possibility of obtaining standardized information to be used for diabetes care profiling and benchmarking activities.
描述糖尿病护理模式并在全国范围内开展基准比对活动。
共有86家诊所参与,所有诊所均使用电子病历。确定了质量指标,并开发了软件,可提取护理质量概况所需的信息。
2004年期间共诊治了114,249例2型糖尿病患者。88.0%的患者至少检测了一次糖化血红蛋白(A1C),64.6%检测了血脂,77.2%检测了血压,48.1%检测了微量白蛋白尿。总体而言,43.1%的患者糖化血红蛋白≤7.0%,36.6%的患者血压≤130/85 mmHg,29.8%的患者低密度脂蛋白胆固醇<100 mg/dl。只有5.5%的患者达到了所有良好预后指标。所有指标在各中心之间均存在很大差异。
本研究是全国质量改进工作的第一步,并证明了获取标准化信息用于糖尿病护理概况分析和基准比对活动的可能性。