Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
Korean J Intern Med. 2019 Jan;34(1):125-136. doi: 10.3904/kjim.2016.136. Epub 2017 Mar 15.
BACKGROUND/AIMS: Due to recent increases in the disease burden of diabetes mellitus, the Health Insurance Review and Assessment Service (HIRA) of Korea implemented a quality assessment of the treatment of diabetes to improve patient care. The present study was conducted to identify any changes after the implementation of the diabetes quality assessment (DQA).
The present study evaluated eight quality assessment indicators that were proposed by the HIRA in all patients with diabetes who visited a university hospital in Korea between 2009 and 2014. The indicators were statistically compared according to the characteristics of the subjects.
There were several significant differences in the indicators among the subjects according to their demographic characteristics. Female patients had a higher continuity of treatment (COT) than that of male patients, and the insulin-treated group had a higher COT than that of the non-treated group, as well as a higher rate of undergoing the diabetes complication tests (DCTs). Patients between 40 and 80 years of age had the highest COT, while patients under 40 years of age had the lowest COT but the highest rate of taking the DCTs. Patients receiving treatment from an endocrinologist exhibited higher numbers of DCTs performed but displayed lower proportions for the prescription indicators.
The present analysis of the DQA findings revealed that endocrinologists combine prevention and management of diabetes complications with measures for glycemic control. Thus, the effective management of diabetes likely entails systematic joint treatment regimens that involve an endocrinologist.
背景/目的:由于糖尿病的疾病负担最近有所增加,韩国健康保险审查和评估服务机构(HIRA)实施了糖尿病治疗质量评估,以改善患者的护理。本研究旨在确定实施糖尿病质量评估(DQA)后的任何变化。
本研究评估了 HIRA 在 2009 年至 2014 年间韩国一家大学医院就诊的所有糖尿病患者中提出的八项质量评估指标。根据受试者的特征对这些指标进行了统计学比较。
根据患者的人口统计学特征,指标在受试者之间存在一些显著差异。女性患者的治疗连续性(COT)高于男性患者,胰岛素治疗组的 COT 高于未治疗组,并且进行糖尿病并发症检查(DCT)的比例也较高。40 至 80 岁的患者 COT 最高,而 40 岁以下的患者 COT 最低,但 DCT 的比例最高。接受内分泌医生治疗的患者进行的 DCT 次数更多,但处方指标的比例较低。
对 DQA 结果的分析表明,内分泌医生将糖尿病并发症的预防和管理与血糖控制措施相结合。因此,有效的糖尿病管理可能需要系统的联合治疗方案,涉及内分泌医生。