Division of Primary Care, Floor 13, Tower Building, University of Nottingham, Nottingham NG7 2RD, UK.
Public Health. 2013 Sep;127(9):814-21. doi: 10.1016/j.puhe.2013.04.015. Epub 2013 Aug 22.
At the time of undertaking the audit, the uptake of diabetic retinopathy screening in Derbyshire was 73%, below the national standard of 80%. To assess equity of access to diabetic retinopathy screening in a geographically and ethnically diverse population and determine predictors for poor uptake that will inform service improvements.
Mixed methods health equity audit.
Postal questionnaires were issued to 1000 people invited for diabetic retinopathy screening in May 2010 and telephone interviews were conducted with subsample of 32 people who had not made a screening appointment. Routine data from the screening programme was used to identify characteristics of people who did not respond to screening invitation. The adjusted odds ratios (OR) and 95% confidence intervals (95% CI) using multivariate methods were calculated in this study.
The response rate to the postal questionnaire was 43%. Of these, 28% of respondents did not recall discussing the importance of diabetic retinopathy screening with their primary care team and 11% of people did not understand the term 'diabetic retinopathy'. Non-uptake of screening was associated with deprivation (OR 1.19, 95% CI 1.10-1.29 for those living in the most deprived areas compared to the least deprived) and young people were over three times more likely not to participate than older people (OR 3.13, 95% CI 2.70-3.64 for men under 40 compared to men over 80 and OR 3.03, 95% CI 1.54-5.98 for people with type 1 diabetes under 40 compared to those over 80).
Ensuring that primary care and other health care and third sector organisations convey the importance of diabetic retinopathy screening with patients and improving patients' understanding of the screening programme may improve uptake. Interventions to increase uptake should be targeted to younger people, especially those with type 1 diabetes and people living in more deprived areas.
在进行审计时，德比郡的糖尿病视网膜病变筛查率为 73%，低于 80%的国家标准。评估在一个地理和种族多样化的人群中获得糖尿病视网膜病变筛查的公平性，并确定影响参与率的因素，以便为服务改进提供信息。
混合方法健康公平审计。
2010 年 5 月，向 1000 名接受糖尿病视网膜病变筛查的人寄出了邮寄问卷，并对未预约筛查的 32 人进行了电话访谈。利用筛查计划的常规数据来确定未对筛查邀请做出回应的人群的特征。本研究使用多变量方法计算了调整后的比值比（OR）和 95%置信区间（95%CI）。
邮寄问卷的回复率为 43%。其中，28%的受访者表示没有回忆起与初级保健团队讨论过糖尿病视网膜病变筛查的重要性，11%的人不理解“糖尿病视网膜病变”一词。未进行筛查与贫困（与最贫困地区相比，居住在最贫困地区的人，OR1.19，95%CI1.10-1.29）和年轻人（与 80 岁以上的人相比，40 岁以下的男性，OR3.13，95%CI2.70-3.64；与 80 岁以上的人相比，40 岁以下的 1 型糖尿病患者，OR3.03，95%CI1.54-5.98）的参与率低有关。
确保初级保健和其他医疗保健及第三部门组织向患者传达糖尿病视网膜病变筛查的重要性，并提高患者对筛查计划的理解，可能会提高参与率。为提高参与率而采取的干预措施应针对年轻人，尤其是 1 型糖尿病患者和生活在贫困地区的人。
