Perrin Byron M, Gardner Marcus J, Kennett Susan R, Cornelius Jodie L, Fanning Michael J
La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
Aust Health Rev. 2012 Feb;36(1):16-21. doi: 10.1071/AH11010.
To ensure an efficient publicly funded podiatric service for people with diabetes in regional Victoria, a Podiatry Diabetes Model (PDM) of care was developed. The aim of this study was to determine if people with diabetes attended the most appropriate podiatric service as depicted by the model.
A 3-month prospective clinical audit of the PDM was undertaken. Primary variables of interest were the podiatric service where the patients were seen and the patients' risk of future foot morbidity. Chi-square analyses for each service category were undertaken to compare the expected number of patients seen according to foot-health risk as predicted by the model, with what was observed.
Five hundred and seventy-six people with diabetes were seen in the 3-month period. There was no statistically significant difference between the proportion of patients seen by each podiatric service according to risk status, with what was expected (community: χ(2)=3.3, P=0.4; subacute: χ(2)=8.0, P=0.05; acute: χ(2)=6.6, P=0.09).
The Podiatry Diabetes Model is a sound podiatric model of care and is an example of cross-organisational collaboration that could be implemented in other areas of Australia.
为确保为维多利亚州农村地区的糖尿病患者提供高效的公费足病医疗服务,制定了足病糖尿病护理模式(PDM)。本研究旨在确定糖尿病患者是否按照该模式所描述的那样接受了最合适的足病医疗服务。
对PDM进行了为期3个月的前瞻性临床审计。主要关注变量为患者接受诊疗的足病医疗服务机构以及患者未来足部发病的风险。针对每个服务类别进行卡方分析,以比较根据该模式预测的足部健康风险所预期的患者就诊人数与实际观察到的人数。
在这3个月期间,共诊治了576名糖尿病患者。各足病医疗服务机构根据风险状况诊治的患者比例与预期比例之间无统计学显著差异(社区:χ(2)=3.3,P=0.4;亚急性:χ(2)=8.0,P=0.05;急性:χ(2)=6.6,P=0.09)。
足病糖尿病护理模式是一种完善的足病护理模式,是跨组织协作的典范,可在澳大利亚其他地区实施。