Lau Ip Tim
Department of Medicine, Tseung Kwan O Hospital, Hong Kong.
Central Committee on Diabetic Services, Hong Kong Hospital Authority, Hong Kong.
Diabetes Metab J. 2017 Apr;41(2):81-88. doi: 10.4093/dmj.2017.41.2.81.
The Hospital Authority of Hong Kong is a statutory body that manages all the public medical care institutions in Hong Kong. There are currently around 400,000 diabetic patients under its care at 17 hospitals (providing secondary care for 40%) and 73 General Outpatient Clinics (providing primary care for 60%). The patient population has been growing at 6% to 8% per year over the past 5 years, estimated to include over 95% of all diagnosed patients in Hong Kong. In order to provide equitable and a minimal level of care within resources and local system factors constraints, a Clinical Practice Guideline on the management of type 2 diabetes mellitus was drawn in 2013 to guide a system approach to providing diabetes care. There is an algorithm for the use of various hypoglycemic agents. An organizational drug formulary governs that less expansive options have to be used first. A number of clinical care and patient empowerment programs have been set up to support structured and systematic diabetes care. With such a system approach, there have been overall improvements in diabetes care with the percentage of patients with glycosylated hemoglobin <7% rising from 40% in 2010 to 52% in 2015.
香港医院管理局是管理香港所有公立医疗机构的法定机构。目前，其下辖的17家医院（提供二级护理服务，占40%）和73家普通科门诊诊所（提供基层护理服务，占60%）共护理约40万名糖尿病患者。在过去5年里，患者人数以每年6%至8%的速度增长，估计涵盖了香港所有已确诊患者的95%以上。为了在资源和当地系统因素的限制下提供公平且最低限度的护理，2013年制定了2型糖尿病管理临床实践指南，以指导采用系统方法提供糖尿病护理。其中有关于使用各种降糖药物的算法。机构药物处方集规定必须首先使用成本较低的药物。还设立了一些临床护理和患者赋权项目，以支持结构化和系统化的糖尿病护理。通过这种系统方法，糖尿病护理总体得到改善，糖化血红蛋白<7%的患者比例从2010年的40%升至2015年的52%。
