Pascual de la Pisa Beatriz, Márquez Calzada Cristina, Cuberos Sánchez Carla, Cruces Jiménez José Miguel, Fernández Gamaza Manuel, Martínez Martínez María Isabel
Servicio Andaluz de Salud, Sevilla, España.
Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla, España.
Aten Primaria. 2015 Mar;47(3):158-66. doi: 10.1016/j.aprim.2014.05.004. Epub 2014 Jun 26.
Pay-for-performance programs to improve the quality of health care are extending gradually, particularly en Primary Health Care. Our aim was to explore the relationship between the degree of compliance with the process indicators (PrI) of type 2 diabetes (T2DM) in Primary Care and linkage to incentives.
Cross-sectional, descriptive, observational study.
Six Primary Health Care centers in Seville Aljarafe District randomly selected and stratified by population size.
From 3.647 adults included in Integrated Healthcare Process of T2DM during 2008, 366 patients were included according sample size calculation by stratified random sampling.
PrI: eye and feet examination, glycated hemoglobin, lipid profile, microalbuminuria and electrocardiogram. Confounding: Age, gender, characteristics town for patients and professional variables.
The mean age was 66.36 years (standard deviation [DE]: 11,56); 48.9% were women. PrI with better compliance were feet examination, glycated hemoglobin and lipid profile (59.6%, 44.3% and 44%, respectively). 2.7% of patients had simultaneous compliance of the six PrI and 11.74% of patients three PrI linkage to incentives. Statistical association was observed in the compliance of the PrI incentives linked or not (P=.001).
The degree of compliance with the PrI for screening chronic complications of T2DM is mostly low but this was higher on indicators linked to incentives.
旨在提高医疗质量的绩效薪酬计划正在逐步推广，尤其是在初级卫生保健领域。我们的目的是探讨初级保健中2型糖尿病（T2DM）过程指标（PrI）的依从程度与激励措施之间的关系。
横断面、描述性观察性研究。
从塞维利亚阿尔哈拉费区随机选取并按人口规模分层的6个初级卫生保健中心。
在2008年纳入T2DM综合医疗过程的3647名成年人中，根据分层随机抽样的样本量计算，纳入了366名患者。
PrI：眼部和足部检查、糖化血红蛋白、血脂谱、微量白蛋白尿和心电图。混杂因素：年龄、性别、患者所在城镇特征和专业变量。
平均年龄为66.36岁（标准差[SD]：11.56）；48.9%为女性。依从性较好的PrI是足部检查、糖化血红蛋白和血脂谱（分别为59.6%、44.3%和44%）。2.7%的患者同时符合所有六项PrI，11.74%的患者三项PrI与激励措施相关。在与激励措施相关或不相关的PrI依从性方面观察到统计学关联（P = 0.001）。
T2DM慢性并发症筛查PrI的依从程度大多较低，但与激励措施相关的指标依从性较高。
