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[格勒诺布尔社区医疗中心2型糖尿病患者的管理]

[Management of type 2 diabetes patients in community health care centers in Grenoble].

作者信息

François Patrice, Pichon Philippe, Poulizac Morgan, Cruaud Anna, Bal Gaelle, Hirsch Martin

机构信息

Unité d'Evaluation Médicale, Pavilion Taillefer, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09.

出版信息

Sante Publique. 2010 Nov-Dec;22(6):665-74.

Abstract

Community health care centers in Grenoble aim to provide quality primary health care, including prevention, to populations living in disadvantaged urban areas. The objective of the study was to assess the quality of follow-up provided by physicians in health care centers in Grenoble to patients with diabetes mellitus. A cross-sectional study was conducted for an observation period of one week in june 2007. All type 2 diabetes patients seen in community health care centers during this given week were included in the study's sample (n=121). During the consultation, the physician collected the data on diabetes follow-up recorded in the patient's medical record over the last year. The data were compared with the recommendations and guidance published by the French National Authority for Health in 2006. The result of a hemoglobin A1c test dated less that three months-old was present in 80% of patients' medical records. Serum creatinine concentration, blood lipids, and microalbuminuria levels were obtained and confirmed with annual tests, and were present and recorded in the last year in 95%, 91%, and 77% of cases, respectively. The patient's weight, recorded within the last year, was noted in all cases. An ophthalmology consultation had been provided within the year for 57% of patients and 55% had received an electrocardiogram. Compliance with French National Authority for Health recommendations for the follow-up of diabetics in the community health care centers was satisfactory. Thus, it seems relevant to analyze their organizational methods.

摘要

格勒诺布尔的社区医疗中心旨在为生活在城市贫困地区的人群提供包括预防在内的优质初级医疗保健服务。本研究的目的是评估格勒诺布尔医疗中心的医生为糖尿病患者提供的随访服务质量。2007年6月进行了为期一周的横断面研究。在该特定周内在社区医疗中心就诊的所有2型糖尿病患者均纳入研究样本(n = 121)。在会诊期间,医生收集了患者病历中记录的过去一年糖尿病随访数据。将这些数据与法国国家卫生管理局2006年发布的建议和指南进行比较。80%患者的病历中有不到三个月的糖化血红蛋白检测结果。血清肌酐浓度、血脂和微量白蛋白尿水平通过年度检测获得并得到确认,分别有95%、91%和77%的病例在去年有记录并保存。所有病例均记录了患者去年的体重。年内57%的患者接受了眼科会诊,55%的患者接受了心电图检查。社区医疗中心对糖尿病患者随访的法国国家卫生管理局建议的依从性令人满意。因此,分析其组织方法似乎很有必要。

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