Center of Experimental and Applied Endocrinology (CENEXA, National University of La Plata-National Research Council of La Plata), PAHO/WHO Collaborating Center for Diabetes Research, Education, and Care, La Plata, Argentina.
Diabetes Res Clin Pract. 2010 Apr;88(1):7-13. doi: 10.1016/j.diabres.2009.12.024. Epub 2010 Feb 12.
To compare clinical-metabolic monitoring and coronary risk status in people with type 2 diabetes from Australia, France and Latin America.
Retrospective analysis of data collected at primary care (except ANDIAB--secondary care) [corrected] matched for age, gender and disease duration. Measurements included participants' characteristics, performance frequency of clinical-metabolic process indicators, and percentage of clinical-metabolic outcomes at recommended target values.
The weighted mean of the percentage of process performance was within 68 to 81%; that of outcomes at target dropped to 29 to 45%. Although statistically significant, differences among groups were far from those in healthcare budgets, and probably only of marginal clinical impact. The percentage of patients with low, slight or high coronary risk was similar in the three groups, with most people at high or very high risk.
Despite the high difference in health per capita investment and system characteristics among countries, the study populations had striking similarities regarding the low percentage of participants who achieved cardiovascular risk factor and diabetes treatment goals. Therefore, differences in health budget and system characteristics would not be the main drivers in care quality. Diabetes education at every level and quality care registries would contribute to improve this situation and assess such improvement.
比较来自澳大利亚、法国和拉丁美洲的 2 型糖尿病患者的临床代谢监测和冠状动脉风险状况。
对初级保健（ANDIAB 除外-二级保健）[更正]收集的数据进行回顾性分析，按年龄、性别和疾病持续时间进行匹配。测量包括参与者的特征、临床代谢过程指标的执行频率以及临床代谢结果达到推荐目标值的百分比。
过程表现的加权平均值在 68%至 81%之间；达到目标的结果则下降到 29%至 45%。尽管存在统计学上的显著差异，但各群组之间的差异远不及医疗保健预算之间的差异，可能仅具有边际临床意义。三组中低、轻度或高冠状动脉风险的患者百分比相似，大多数人处于高或极高风险。
尽管各国的人均卫生投入和系统特征存在很大差异，但研究人群在心血管风险因素和糖尿病治疗目标方面达到的参与者百分比却惊人地相似。因此，卫生预算和系统特征的差异并不是护理质量的主要驱动因素。在各个层面进行糖尿病教育和质量护理登记将有助于改善这种情况，并评估这种改善。
