Fogelman Yacov, Karkabi Khaled, Goldfracht Margalit
Department of Family Practice, Leumit Health Services, Tel Aviv-Yafo, Israel.
The Ruth & Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel;
J Community Hosp Intern Med Perspect. 2016 Apr 25;6(2):31204. doi: 10.3402/jchimp.v6.31204. eCollection 2016.
AIMS/INTRODUCTION: Family physicians face the dilemma of when to refer patients with diabetes to specialists. This study examined attitudes of family physicians to referring patients with poor glucose control to diabetes specialists.
At continuous medical education courses, family physicians were asked to respond anonymously, as to whether they generally manage the diabetes of their patients, and specifically those with poor glycemic control (HbA1c>9.0%).
Of 470 respondents, 426 (90%) reported that they generally manage their patients' diabetes; 202 (43%) reported that they manage the diabetes of patients with HbA1c>9.0%. Board certification in family medicine and affiliation to a health maintenance organization, but not sex, age, years of professional experience, or the proportion of patients with diabetes at their clinics, were associated with referral practices.
Family medicine residency and organizational support appear to promote treatment by family physicians of patients with poorly controlled diabetes in the primary care setting.
目的/引言：家庭医生面临着何时将糖尿病患者转诊给专科医生的困境。本研究调查了家庭医生对于将血糖控制不佳的患者转诊给糖尿病专科医生的态度。
在继续医学教育课程中，要求家庭医生匿名回答他们是否通常管理患者的糖尿病，特别是那些血糖控制不佳（糖化血红蛋白>9.0%）的患者。
在470名受访者中，426名（90%）报告他们通常管理患者的糖尿病；202名（43%）报告他们管理糖化血红蛋白>9.0%患者的糖尿病。家庭医学委员会认证以及隶属于健康维护组织与转诊行为相关，而性别、年龄、专业经验年限或其诊所中糖尿病患者的比例则与之无关。
家庭医学住院医师培训和组织支持似乎促进了家庭医生在初级保健环境中对糖尿病控制不佳患者的治疗。
