Primary Care Center (PCC) La Mina, Sant Adrià de Besòs, Barcelona, Spain.
Int J Clin Pract. 2012 Mar;66(3):289-98. doi: 10.1111/j.1742-1241.2011.02872.x.
To assess the evolution of type 2 diabetes mellitus (T2DM) quality indicators in primary care centers (PCC) as part of the Group for the Study of Diabetes in Primary Care (GEDAPS) Continuous Quality Improvement (GCQI) programme in Catalonia.
Sequential cross-sectional studies were performed during 1993-2007. Process and outcome indicators in random samples of patients from each centre were collected. The results of each evaluation were returned to each centre to encourage the implementation of correcting interventions. Sixty-four different educational activities were performed during the study period with the participation of 2041 professionals.
Clinical records of 23,501 patients were evaluated. A significant improvement was observed in the determination of some annual process indicators: HbA(1c) (51.7% vs. 88.9%); total cholesterol (75.9% vs. 90.9%); albuminuria screening (33.9% vs. 59.4%) and foot examination (48.9% vs. 64.2%). The intermediate outcome indicators also showed significant improvements: glycemic control [HbA(1c) ≤ 7% (< 57 mmol/mol); (41.5% vs. 64.2%)]; total cholesterol [≤ 200 mg/dl (5.17 mmol/l); (25.5% vs. 65.6%)]; blood pressure [≤ 140/90 mmHg; (45.4% vs. 66.1%)]. In addition, a significant improvement in some final outcome indicators such as prevalence of foot ulcers (7.6% vs. 2.6%); amputations (1.9% vs. 0.6%) and retinopathy (18.8% vs. 8.6%) was observed.
Although those changes should not be strictly attributed to the GCQI programme, significant improvements in some process indicators, parameters of control and complications were observed in a network of primary care centres in Catalonia.
评估 2 型糖尿病（T2DM）质量指标在初级保健中心（PCC）的演变情况，该研究为加泰罗尼亚初级保健糖尿病研究组（GEDAPS）持续质量改进（GCQI）计划的一部分。
在 1993 年至 2007 年期间进行了一系列的横断面研究。从每个中心的随机患者样本中收集了过程和结果指标。每次评估的结果都会反馈给每个中心，以鼓励实施纠正干预措施。在研究期间，共开展了 64 项不同的教育活动，有 2041 名专业人员参与。
共评估了 23501 名患者的临床记录。一些年度过程指标的测定有显著改善：糖化血红蛋白（HbA1c）（51.7% vs. 88.9%）；总胆固醇（75.9% vs. 90.9%）；白蛋白尿筛查（33.9% vs. 59.4%）和足部检查（48.9% vs. 64.2%）。中间结果指标也有显著改善：血糖控制[糖化血红蛋白（HbA1c）≤7%（<57mmol/mol）；（41.5% vs. 64.2%）]；总胆固醇[≤200mg/dl（5.17mmol/l）；（25.5% vs. 65.6%）]；血压[≤140/90mmHg；（45.4% vs. 66.1%）]。此外，一些最终结果指标的患病率也有显著改善，如足部溃疡（7.6% vs. 2.6%）；截肢（1.9% vs. 0.6%）和视网膜病变（18.8% vs. 8.6%）。
尽管这些变化不应严格归因于 GCQI 计划，但在加泰罗尼亚的初级保健中心网络中，观察到一些过程指标、控制参数和并发症的显著改善。
