Department of Family Medicine and Primary Health Care, United Christian Hospital, Kowloon East Cluster, Hospital Authority, Hong Kong SAR, China.
Fam Pract. 2012 Apr;29(2):196-202. doi: 10.1093/fampra/cmr060. Epub 2011 Sep 2.
Little is known about the quality of care for patients with Type 2 diabetes in primary care setting in Hong Kong.
To investigate the quality of care for patients with Type 2 diabetes in Hong Kong primary care setting and potential disparities by patient characteristics and clinics.
Cross-sectional study in three general outpatient clinics (GOPCs; public primary care clinics) in Hong Kong involving 1970 patients. Main outcome measures were achievement rates of seven process measures and three intermediate outcome targets and adjusted odds ratios of age, sex, socio-economic status and clinic on the quality measures.
The achievement rates for the recording of HbA1c, blood pressure (BP), cholesterol, body mass index, smoking status, nephropathy screening and retinopathy screening in the previous 12 months were 92.8%, 99.9%, 91.0%, 47.9%, 91.3%, 69.0% and 38.0%, respectively. A total of 58.0%, 38.2% and 36.4% of patients achieved the glycaemic, BP and cholesterol targets, respectively. Older patients were less likely to have records of process measures and more likely to achieve the HbA1c target. Women were less likely to have smoking status recorded and to achieve the HbA1c target. Patients of lower socio-economic status were less likely to have records of process measures and to achieve the BP target. Family medicine training practices had better achievements of the quality measures.
There is scope for improvement in the quality of diabetes care in the GOPCs. Variations in the quality of care were observed. Family medicine training may enhance the health care quality.
对于香港基层医疗环境中 2 型糖尿病患者的护理质量，人们知之甚少。
调查香港基层医疗环境中 2 型糖尿病患者的护理质量，并按患者特征和诊所情况分析潜在差异。
这是一项在香港 3 家普通门诊诊所（GOPC；基层医疗诊所）进行的横断面研究，共纳入 1970 例患者。主要结局指标为过去 12 个月内 7 项流程指标和 3 项中间结局目标的达标率，以及年龄、性别、社会经济地位和诊所对质量指标的调整比值比。
过去 12 个月内 HbA1c、血压（BP）、胆固醇、体重指数、吸烟状况、肾病筛查和视网膜病变筛查的记录达标率分别为 92.8%、99.9%、91.0%、47.9%、91.3%、69.0%和 38.0%。共有 58.0%、38.2%和 36.4%的患者达到了血糖、BP 和胆固醇目标。年龄较大的患者接受流程措施记录的可能性较小，而达到 HbA1c 目标的可能性较大。女性更不可能记录吸烟状况，也更不可能达到 HbA1c 目标。社会经济地位较低的患者接受流程措施记录的可能性较小，达到 BP 目标的可能性也较小。家庭医学培训实践在质量指标的达成方面表现更好。
GOPC 中糖尿病护理质量仍有提升空间。观察到护理质量存在差异。家庭医学培训可能会提高医疗保健质量。
