Lawrenson Ross, Gibbons Veronique, Joshy Grace, Choi Peter
Waikato Clinical School, The University of Auckland, Hamilton, New Zealand.
J Prim Health Care. 2009 Sep;1(3):177-83.
To estimate the prevalence of diabetes by age, gender and ethnicity; to look at quality of care and to investigate disparities in care.
A cross-sectional study in three practices in Hamilton. A comprehensive register was generated by identifying patients with diabetes through queries on the practices' computer system looking for diagnosis codes for diabetes, prescription of hypoglycaemic agents, participation in the 'Get Checked' programme or laboratory test for HbA1c. We then compared the glycaemic control and uptake of retinal screening in adult patients with Type 2 diabetes.
The overall prevalence of diabetes in patients aged 20 years or older was 1221/26 096 (4.7%). Eighty percent had attended for a 'Get Checked' annual review in the last 12 months. After adjusting for age, we found that Maori, males and those diagnosed more than five years ago were at increased risk of having unsatisfactory glycaemic control. Maori or Asian patients and women appeared less likely to have accessed retinal screening in the last two years.
Computerised records including diagnostic codes and prescriptions in general practices can be used to develop comprehensive diabetes registers. Whilst this study shows that high levels of annual review can be achieved in patients with diabetes, the next challenge is to tackle the disparities in uptake of services such as retinal screening or the achievement of intermediate outcomes such as good glycaemic control.
按年龄、性别和种族估算糖尿病患病率；观察护理质量并调查护理方面的差异。
在汉密尔顿的三家诊所开展一项横断面研究。通过查询诊所计算机系统中糖尿病诊断代码、降糖药处方、参与“接受检查”项目或糖化血红蛋白实验室检测来识别糖尿病患者，从而生成一份综合登记册。然后，我们比较了成年2型糖尿病患者的血糖控制情况和视网膜筛查的接受率。
20岁及以上患者中糖尿病的总体患病率为1221/26096（4.7%）。80%的患者在过去12个月内参加了“接受检查”年度复查。在对年龄进行调整后，我们发现毛利人、男性以及五年多前被诊断出糖尿病的患者血糖控制不理想的风险增加。毛利人或亚洲患者以及女性在过去两年中接受视网膜筛查的可能性似乎较小。
全科诊所中包括诊断代码和处方在内的计算机化记录可用于建立综合糖尿病登记册。虽然这项研究表明糖尿病患者的年度复查率较高，但下一个挑战是解决视网膜筛查等服务接受率方面的差异，或实现血糖良好控制等中间结果方面的差异。
